Health Matters Winter 2011 by HSE Communications

HEALTH Vol 7 I Issue 4 I Winter 2011

INSIDE - COMMUNITY NURSING - BOUNCE PROGRAMME - VOLUNTEER ADVOCATES - INFANT IMAGININGS

MATTERS National Staff Magazine of the Health Service Executive

H E A LT H

I Issue 3 I Autumn 2009

MATTERS

ional Staff Magazine of the Health Service Executive

GETTING BACK ON TRACK ADVENTURER National Staff Newsletter of the Health Service Executive MARK POLLOCK

matters Vol 4 I Issue 2 I Summer 2009

HEALTH 11

National Staff Magazine of the Health Service Executive

HEALTHMATTERS Vol 5 I Issue 3 I Autumn 2009

Merry Christmas and Happy New Year to all HSE Staff from Front Cover7.4.indd 1

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Health Matters 1

Welcome... … to the winter edition of Health Matters, the national staff magazine of the HSE. In this issue we feature HSE members of staff who will spend Christmas Day working. We talk to Nichola Walsh, a Clinical Nurse Manager in Our Lady’s Children’s Hospital, Crumlin. Nichola won’t make it back to her native Mayo for Christmas Day but will instead spend it making the day extra special for her young patients. We take a closer look at the new HSE Child and Adolescent Psychiatric Unit, Cork which won Best Health Building in the 2011 Irish Architecture Awards, and the Child and Adolescent Mental Health Unit at Merlin Park Hospital, Galway which was shortlisted in the Best Health and Leisure category. Elsewhere, we look at a TV series to be broadcast in the New Year on RTÉ which will focus on the role of Public Health Nurses. Six Nurses working in communities around Ireland will feature in the new series. Finally, Dr Fidelma Fitzpatrick, Consultant Microbiologist and Clinical Lead for the Prevention of Healthcare-Associated Infection tells us about the HSE’s major public health campaign to let people know that antibiotics are wasted on colds and flu. We hope you find this issue’s mix of features, interviews, news and updates of interest. For more regular updates, check out our staff Intranet site, http://hsenet.hse.ie, or the HSE website, www.hse.ie. I would also like to wish all of our readers and contributors a very happy Christmas.

Sites We Like... www.patientsafetyfirst.ie

www.yourmentalhealth.ie

Stephen McGrath, Editor Head of Internal Communications

The magazine is produced by the HSE Communications Directorate Publishers: Ashville Media – www.ashville.com Feedback: Send your feedback to internalcomms@hse.ie

www.bonehealth.co

Did you know? • Community and Public Health Nurses make almost 10,000 house calls every day in every corner of Ireland www.hselibrary.ie

• Mother’s milk can provide all the nutrients needed for the first six months for most healthy full-term infants • More than 3,600 foster families in this country quietly provide family–based care to over 5,500 children The information in Health Matters is carefully researched and believed to be accurate and authoritative, but neither the HSE nor the publisher can accept responsibility for any inaccuracies, errors or omissions. Statements and opinions expressed herein are not necessarily those of the Editor, the HSE or of the publisher. Advertisements within the publication are not endorsed by the HSE or the publisher. Any claims made within the advertisements are not endorsed by the HSE or the publisher. Advertising or editorial promotion in this publication is unrelated to and unconnected with any tender process or contract award that is ongoing or completed in the HSE.

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2 HEALTH MATTERS

CONTENTS

WELCOME

BOUNCE PROGRAMME

CROKE PARK AGREEMENT Update

TALLAGHT HOSPITAL

HSE BUILDING WINS TOP ARCHITECTURE AWARD

ADVOCACY FOR OLDER PEOPLE Taking a closer look at how volunteer advocates support nursing home residents DO YOU WANT TO STOP SMOKING? Dr Jose Ayala has some great tips on how to QUIT OPENING OF CRUMLIN CF UNIT Report on the CF Unit which officially opened in October NIMIS PROJECT UPDATE Prof Neil O’Hare gives an update on the NIMIS project INFANT IMAGININGS Babies benefit from music, performance and play. PUBLIC HEALTH NURSES ON RTE SHOW A new TV series ‘The Nurse’ is to focus on the role of public health nurses in Ireland.

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ANTIBIOTICS UPDATE Find out why antibiotics are wasted on colds and flu.

NIGHT OWLS Hospital Intern, Kapil Sharma, writes about working nights.

DR. RICHARD STEEVENS’ SCHOLARHIP

SCHOOL HEALTH PACK

MASTERCHEF Occupational therapist Bridin Carey tells us about her Masterchef experience

MARK POLLOCK His greatest challenge

CLINICAL PROGRAMMES A report from the HSE’s first Nurse and Midwife Prescribing Conference

COPD Campaign raises awareness of COPD

EXTREME MARATHONS

WASTE MANAGEMENT Festive recycling

DATA PROTECTION 68

LIBRARY SERVICES UPDATE Find out what’s available

CAPITAL DEVELOPMENTS Mater - Waterford - Glenties

70 34

PLANTMARKET Find out why this is the ideal time to plan your garden for next summer.

REGIONAL PAGES News from all the regions of the HSE

NEWS IN BRIEF A round up of all the latest news and events

CHILDREN FIRST

RECRUITING FOSTER FAMILIES

OPENING OF LAURALYNN HOUSE A report on Ireland’s first children’s hospice

SPORTING PASSIONS Pharmacist Miriam Wall on competing in triathlons.

GETTING TO KNOW YOU

WINTER HEALTH

ME & MY LIFESTYLE

WORKING OVER CHRISTMAS HSE staff share their experiences

COCHLEAR IMPLANTS

A DAY IN THE LIFE Consultant Cardiologist, Dr. Caroline Daly writes about her work at St. James’s Hospital.

AIR AMBULANCE SERVICE Report on HSE Air Ambulance Service

PRIMARY CARE TEAMS A new PCT training resource is now available

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Another major success for Emergency Departments

Introducing AlEx Automated Linen Control Systems Successfully trialled in St. James Hospital, Dublin – Emergency Department. Proven to reduce clinical laundry daily usage by 25% to 40% Ensuring cash releasing saving back into clinical budgets. 10 year successful history in the United States The AlEx automated linen control systems are designed to: • Ensure individualised accountability and responsibility for all laundry usage. • Ensure clinical departments and ambulance personnel are never short of laundry supplies as the IT system can remotely communicate with laundry departments. • Improve departmental aesthetics as well as ensuring greater departmental efficiencies and usage of laundry supplies. • Assist in reducing cross-contamination as laundry is now stored away from non-hospital personnel. • Fit into all clinical areas as the AlEx Footprint is relatively small and unique. • Work in conjunction with your existing laundry suppliers and team • Use the same IT platform management systems as the Scrubex automated scrubs suit systems, so easily integrated. • Low cost rental option available

NB – Linen, laundry and scrub suits are a scarce resource, therefore the automation of these resources will maximise clinical, psychological and economical benefits for staff, patients and hospital budgets. For a 30 day trial or to find out more in relation to how AlEx and Scrubex Automated Linen Distributing Centres can assist your clinical department, please contact: O’ Flynn Medical Ltd Locall 1890 440440 or email: info@oflynnmedical.com Cork Office: O’ Flynn Medical Ltd, Millstreet, Co. Cork. Tel: 029 21799, Fax 029 70191 Dublin Office: O’ Flynn Medical Ltd, Castleknock, Dublin 15. Tel: 01 8227065

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HealtH Matters 5

HealtH promotIon

BounCe – BuilT To MoVe galway’s successful physical activity and lifestyle awareness programme for overweight and obese children.

he Galway Health Promotion and Community Nutrition and Dietetics services ran a pilot 12-week physical activity and lifestyle awareness programme for nine to 12-year-old overweight and obese children from June to september. the programme was organised in partnership with titans Basketball Club, a Galway City-based club that focuses on providing the opportunity to play basketball to children and youths from all sections of the community. the aim of the programme was not weight reduction but rather to motivate the children to increase their physical activity, make better food and recreational choices, and incorporate these basic lifestyle changes into their daily lives. the programme involved two one-hour physical activity sessions each week with the Head Coach of titans Basketball Club, along with information sessions on nutrition and motivational support for both the children and parents. a baseline on activity level was measured before the programme started by giving each child a pedometer to wear for a set period. In addition, parents completed a lifestyle survey, which measured the children’s sedentary behaviour (time spent watching tV, etc.) and nutritional intake. the activity levels were measured once more at the end of the programme and the lifestyle questionnaire was completed again. In addition, anthropometric measurements were recorded at the start and again in Week 12.

PosiTive resulTs Paul Gillen, Health Promotion Officer, was one of the organisers of the programme. He said, “the focus was on helping to prevent overweight children from putting on any more weight so that they can grow into their present weight. We are delighted with the results. Many of the children joined the programme having low levels of physical activity and some with low levels of selfesteem. Now they are motivated to keep up the good habits they learned and are continuing to use their ball skills both on the

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the organisers of the ‘BOUNCe – Built to Move’ physical and lifestyle awareness programme organised by the Hse in partnership with titans Basketball Club (l-r): Joe Coughlan, Head Coach, titans BC; Frank Cashman, Honorary President, titans BC; lisa Corbett, Hse Community Nutrition and Dietetic service; Will achambault, UsNI Victory scholar, titans BC; adrienne lynam, Project Manager, Hse action on Obesity; Matt lint, Coach of Coaches, titans BC; Paul Gillen, Hse Health Promotion Officer; and tim Coyne, UsNI Victory scholar, titans BC.

basketball court and among their family and friends at home. “the activity programme was designed so that the children increased their enjoyment of being active through fun-based games and activities,” he added. “the key element in the transformation of the children involved in the programme was the ongoing engagement and commitment of their parents. the family influence and lifestyle has a much more important role than any outside influence and it was not surprising to us that the kids who completed and gained most from the programme were those whose parents were enthusiastic, participated and demonstrated their support of the programme and, most importantly, their child.” lisa Corbett, Primary Care Nutritionist, was involved in providing information sessions on nutrition. she said, “the attendance of the parents and the children at the nutrition workshop, cookery demonstration and supermarket nutrition tours demonstrated a huge level of interest in learning about making healthier food

choices. Finding out about the quantity of sugar in many children’s food and drink choices has already led to changes in shopping and eating habits in these families.” Paul Gillen is now developing a blueprint programme which can be adapted for any club or community organisation interested in organising a similar physical activity and lifestyle awareness programme. For more information contact Paul Gillen, Health Promotion Department, Hse West, on (091) 548323 or email paul.gillen@hse.ie.

titan tigers take on the BOUNCe Demons: Children participating in the programme challenge their basketball coaches.

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6 Health Matters

update

Croke Park Agreement: The challenge of change More updates on progress being made in relation to the implementation of the Croke Park Agreement in the Health Sector.

he Public Service Agreement, also known as the Croke Park Agreement, aims to achieve substantial savings and efficiencies predominantly through the reduction of staff numbers in the health sector and the subsequent redeployment of staff to protect and, where possible, enhance service delivery in priority areas.

Redeployment The Agreement in the health sector includes a Redeployment Protocol which was agreed between management and unions. This protocol states that redeployment will be organised in a manner which maximises the efficient and effective deployment of resources while recognising the rights, entitlements and needs of the employee. The number of HSE staff redeployed or reassigned in 2011 is estimated to be approximately 1,770. In addition to these permanent redeployments, there has been a positive level of engagement by staff across the sector in short-term redeployment, flexibility, mobility and interchangeability. Even with this high level of redeployment, only a small number of cases have been referred to adjudication under the agreed appeals procedures set out in the Health Sector Redeployment Protocol. Work Practice Changes In accordance with the provisions of the

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©istockphoto.com/VELevi

Staff Reduction The Croke Park Agreement was reached in 2010. The number employed in the health service stood at 112,771 at its peak in 2007. Since then the overall number employed has fallen to 104,065. Further reductions are planned over the next three years by government which would reduce the overall number employed to 98,750.

Croke Park Agreement, progress is being made in implementing changes to work practices and in developing services around the country. Here are some examples of what is being achieved:

Children’s Palliative Care An overarching aim in Children’s Palliative Care is to enable children who need this service to be cared for at home to the greatest extent possible. In order to support this aim, eight nurses are to be re-designated as Outreach Nurses for Children’s Palliative Care. The development and maintenance of linkages between specialist and community settings are an integral part of the outreach posts.

Two Outreach Nurses are currently in place – one in Drogheda and one based in the Children’s University Hospital, Temple St. Posts for Waterford, Cork and Limerick are due to be filled. The two posts for Dublin Mid-Leinster and the post for Galway will be recruited shortly by Our Lady’s Hospice and Milford Hospice, under a Memorandum of Understanding between these bodies and the HSE. Each nurse will be supported by agreed national and local governance structures which will include a local Consultant with a specific interest in paediatric palliative care, a Director of Nursing and a representative from local primary care services. This will ensure a coherent approach across the regions.

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Health Matters 7

update “In accordance with the provisions of the Croke Park Agreement, progress is being made in implementing changes to work practices and in developing services around the country.”

Intellectual Disability Services reach agreements under Croke Park A number of intellectual disability services in the Dublin area have reported reaching agreements under the Croke Park Agreement which will deliver changed work practices, organisational reform and savings. At St. Michael’s House an agreement has been reached with SIPTU, IMPACT and the INMO. The agreement covers 1,542 workers and aims to save over s3m up to 2014. It involves an extended working day from 8am to 8pm, with staff available 5 days over 7, and a redeployment/re-assignment protocol. It also includes the introduction on a pilot basis of an online rostering system. A major part of the savings in the St Michael’s House agreement comes from the integration of the transport department with the day and residential services. At Cheeverstown House, a cost saving agreement has been reached which will deliver s435,000 in savings. The Louth Meath Hospitals Stroke Service The Stroke Rehab Unit in Louth County Hospital, Dundalk, opened in 2011 and 41 Nursing and Health Care Assistant staff transferred into the Unit and the step-down service in the hospital. Ten dedicated acute stroke beds have opened in Our Lady of Lourdes Hospital, Drogheda, and ward catering hours have being extended to 8pm by catering/ household staff there.

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Sligo/ Leitrim Mental Health Service The Sligo Leitrim Mental Health Service is implementing Vision for Change and reconfiguring existing service to meet the needs of patients into the future. The process involves the reconfiguring and redeployment of resources from existing high, medium and low support client accommodation provided by the service in the community to provision of independent accommodation by local authorities/providers and supported by appropriate health staff. It also involves the redeployment of staff to different locations to facilitate change and continue to provide service in an environment of reducing resources. To ensure the service was in line with best practice a full multi-disciplinary review of all long term residents/patients and their needs was undertaken and as a result patients are being more appropriately placed in the community. This process and positive engagement by staff represented has resulted in the service developing two multidisciplinary community mental health teams with clinical team meetings and reviews of patients taking place in the community, coordinated on interim basis by the Assistant Director of Nursing to the benefit of patients, staff and service. Background Sligo Leitrim Mental Health Service, while having a history of innovative change, had found that progress was limited in recent years in relation to implementing change around rostering and service development. To address the situation an initiative

around ‘work life balance’, under the mentorship of Partnership Facilitator Billy Gallagher and his team, was developed. This initiative facilitated both staff and management to implement change in these areas for the benefit of all. The process set the tone for a very positive working initiative supported by a structured framework under the terms of the Croke Park Agreement. The service has, as result of good working facilitated by the Croke Park Agreement, reconfigured three supervised residences. This has released resources to develop the provision of a team base to enhance team functioning and ensure appropriate treatment and care planning in community. It has also enhanced the Community Mental Health Nursing Team and developed Liaison Mental Health Nursing in Sligo General Hospital. Working with North Leitrim Men’s Group has also been enhanced and the provision of Cognitive Behaviour Nurse Psychotherapy (CBT) provided to Primary Care (GPs) has also benefitted . Other benefits include the enhancement of Occupational Therapy and the automation of switchboard out of hours to release clerical resources to focus on provision of clinical support. Account/financial reporting has been centralised and a Community based Rehabilitation and Recovery Multidisciplinary Assertive Outreach Team provided. Those involved included the multidisciplinary team, including consultant psychiatrist and NCHD, nursing, social work, occupational therapy, administration, clients/patients and their families and relatives and staff representatives of SIPTU and the PNA.

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Health Matters 9

nursing

Measuring Nursing Care at Tallaght Hospital Almost a year in place, the Nursing Instrument for Quality Assurance (NIQA) is a robust mechanism to continuously measure the contribution of nursing care. Since its implementation, the initiative has proved very positive for patients and nursing care. The project has received recognition from other organisations as a leading initiative on nursing indicators in Ireland and has been presented at a number of peer-reviewed conferences, according to Philippa Ryan Withero, Acting Nurse Practice Development Advisor, Tallaght Hospital.

n today’s healthcare environment there is an increased focus on the necessity to measure care outcomes in order to determine the effectiveness of care delivery. It is with in mind that the Nursing Service of Tallaght Hospital, under the leadership of Ann Donovan, Director of Nursing, embarked on an initiative to specifically measure the contribution of our nursing care, known as the Nursing Instrument for Quality Assurance (NIQA).

Nursing Instrument for Quality Assurance The journey towards embedding this initiative in Tallaght Hospital started with a review of the available literature and best practice examples on how to comprehensively measure nursing care along with its impact to patients. We sought to identify measures that would reflect and demonstrate the contribution of nursing care to patient outcomes.

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Pictured (l-r): Elizabeth Kinlan, Bernadette Corrigan, Philippa Ryan Withero, Maeve Murphy, Paudy O’ Gorman, Sinéad Tougher and Elsamma Philip.

Nine measures of nursing care Nine nursing-sensitive outcome indicators were identified as appropriate measures of nursing care to best meet our goal, which was to identify and implement a robust mechanism to measure and improve patient care outcomes through nursing care input. The nine indicators chosen for measurement are: • Nursing documentation • Falls • Tissue viability • Medication management • Clinical observations • Pain • Nutrition • Discharge planning • Patient experience

commenced in November 2010. In order to develop and implement this process of

“The measurement framework also includes a defined target to be achieved within each indicator and is arranged in a traffic light system of green, amber and red.”

The project, led by myself, as Acting Nurse Practice Development Advisor,

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10 Health Matters

nursing measuring nursing care, a series of steps were undertaken to ensure successful implementation.

Measurement framework Following the identification of the nine indicators, a quality measurement framework was designed to contextualise the process for the NIQA, which includes: • The nursing-sensitive indicators, as already identified • Practice standards • Measurement • Improvement • Monitoring In order to measure practice, the standards were used to design an audit tool for measuring specific components of practice. Inclusive within this measurement are incident rates, for example, falls incident rates, which provide additional insights into parallels between practice standards and patient outcome. The measurement framework also includes a defined target to be achieved within each indicator and is arranged in a traffic light system of green, amber and red. Once measurement information is gathered, the process moves into the improvement phase whereby the measurement results reveal areas of good practice in addition to those areas of practice requiring improvement, which are then acted upon. Finally, monitoring ensures there is an ongoing review of nursing practice and patient outcome, which continuously improves care.

Nursing Auditors The process of the NIQA is one which is led and driven by our Nursing Service. Measurement of nursing care is undertaken every two months in each of the in-patient clinical areas by our Assistant Directors of Nursing. Our Nurse Practice Development Department acts as Auditors, taking a fifth of all patients. To ensure validity and reliability of the process, our Nursing Auditors have been specifically trained and educated in this process and only audit in clinical areas outside of their individual operational responsibility. Similarly, ensuring validity and reliability for measurement of patient experience,

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these Auditors are non-nursing personnel, specifically educated and trained on the process, and come from our hospital Management Team, process improvement, allied health professionals and patient advocacy.

“To date, six audit cycles have been completed revealing a consistent increase in indicator results over time, achieving a green indicator result on all organisation indicators.”

Results All data is collected every two months and is then collated and analysed by our Informatics Nurse, Geraldine Hiney, who is integral to the process. The results provide valuable and meaningful information on nursing care and patient outcomes. The results detail overall organisational performance in relation to each of the nine indicators within the target ranges of green (target met), amber (less than 70 per cent of target met), and red (less than 60 per cent of target met). Any indicator returned as amber or red automatically requires improvement and action planning as part of the NIQA improvement phase in order to achieve a green or amber rating on subsequent measurement. In addition to the overall organisational results, each clinical area receives their individual results for each indicator. Further detailed results and analysis on each question within each indicator are available, which facilitates greater meaning and understanding of areas for improvement. A risk rating category has also been applied to each indicator question to facilitate identification of those indicators requiring immediate action related to patient outcome. Additionally, incident rates are analysed in order to demonstrate the

parallels between care input and patient outcomes such as fall rates. This data is facilitated in collaboration with our Clinical Risk Management Department.

Progress To date, six audit cycles have been completed revealing a consistent increase in indicator results over time, achieving a green indicator result on all organisation indicators. This is significant not only in terms of this initiative but, more importantly, in terms of its meaning for patient care, experience and outcome. The availability of key information on nursing care provides the focus on where improvements on patient care can be made and, indeed, equally on those areas where successes can be celebrated and shared. The success of this initiative is as a direct result of the genuine investment and support of our Director of Nursing, Deputy Director of Nursing, Assistant Directors of Nursing, Clinical Nurse Managers, Nurse Practice Development Department and our Nurses. Equally, we would like to thank Michael Shannon, HSE Nursing Services Director and Liz Roche, Nursing and Midwifery Practice Development Unit Director, for their support of this initiative. Future plans Our plans for the future of this initiative in 2011/2012 are to: • Extend the NIQA to specialist areas including children’s care and haemodialysis (for which work has already begun), and the Emergency Department, Coronary Care Unit and Intensive Care Unit • Share the patient experience results on a regular basis with our hospital patient forum group • Use hand-held tablet devices to capture audit data in the clinical areas • Explore the benefits of this initiative for Nurse Managers We would like to take this opportunity to thank the Nursing Service of Tallaght Hospital for their continued support and investment in this initiative. For further information, please contact Philippa Ryan Withero, Acting Nurse Practice Development Advisor, The Adelaide & Meath Hospital Incorporating The National Children’s Hospital, Tallaght, Dublin 24; Tel: (01) 414 4130; Email: phillippa.ryanwithero@amnch.

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estates

HSE buildings gain recognition at Irish Architecture Awards The new HSE Child and Adolescent Psychiatric Unit in Cork was named the Best Health Building in this year’s Irish Architecture Awards, while the Child and Adolescent Mental Health Unit at Merlin Park Hospital, Galway was also shortlisted in the Best Health and Leisure category.

The HSE’s award winning Child and Adolescent Psychiatric Unit in Bessboro, Cork.

Best in Health n the following paragraphs, Architect Valerie Mulvin of McCullough Mulvin Architects tells us about the award-winning Child and Adolescent Psychiatric Unit in the Sacred Heart Convent, Bessboro, Cork.

Bessboro House, a fine 18th century house in a landscaped demesne, has been a therapeutic campus for many years under the auspices of the Sacred Heart Sisters. The nuns built a chapel and a maternity hospital for unmarried mothers in the 1920s, and the building had a long and sad history as a place where young girls from the area went to have their babies and give them

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up for adoption. The babies were adopted to American families right up to the 1960s and, even today, people come back to the building wanting to see the place where they were born. Recent history has judged harshly the mores of former times, and the religious orders who built and funded these buildings at a time when the State was effectively washing its hands of providing support to people in trouble. The hospital and chapel were acquired by the State and became the site of a new Vision for Change project by the HSE to build facilities for children and young people with mental health difficulties in the southern region. Comprising a 20-bed in-patient unit,

“The older buildings are like rocks in a sea of timber and greenery, linked and softened by a unifying coat of white paint.”

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12 Health Matters

estates therapy and assessment areas, and a linked school to enable children to continue their education while in the unit, the Child and Adolescent Psychiatric Unit provides care and support for children between the ages of 12 and 16 years who are affected by conditions ranging from depression, schizophrenia and self harm, to anorexia and behavioural difficulties.

A Model Home On this beautiful site, challenges included institutional planning, north-facing yards and acres of tarmac. The project took a sustainable approach by engulfing usable older buildings while acknowledging their memory and history. Patterns of use were reversed with the addition of a new entrance block on the north side, on the site of the old outdoor yards, and a sweep of new rooms around a new garden on the south. The reuse of old building stock not only minimises waste and demolition, but it puts nature at the centre of recovery. We reoriented the complex, linking the old buildings with a timber and zinc canopy across the gardens. New rooms are clad in a timber rain-screen, with folded zinc roofs, and roof lights and large areas of glazing bringing light deep into the plans. The older buildings are like rocks in a sea of timber and greenery, linked and softened by a unifying coat of white paint. The brief was to encompass the whole life of a child who might be in the unit for a period of weeks or months, so the intent was to come as close to a paradigm of home as possible. While all the normal technical facilities are provided, these are set within a cocoon of domesticity, so children and staff eat together in a bright dining space overlooking the garden, there are fireplaces in warm sitting rooms, a tiny library, games rooms, computer areas and TV rooms, all with views to landscape. Therapy and day treatment rooms are at ground level with games rooms creating a relaxed atmosphere close to the entrance, welcoming newcomers. The 20 en suite bedrooms (including intensive care facilities) are grouped together in fours on the first floor of the old hospital building, using colour coding and seating to give identity to small groups of children. A Safe and Open Environment One of the major challenges internally was anti-ligature design and detailing – every aspect of the building and its materials had to

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be considered as to how an occupant could use or abuse it, from windows for natural ventilation, glass safety and impact loadings, to handrail design, anti-ligature handles and sanitary fittings. Combining very heavy duty robustness with a feeling of openness and light was a challenge which we handled with the cooperation and enthusiasm of the HSE and unit staff.

Voids are cut through old fabric to bring light deep into the plan, and full-height glass screens allow for views and connections from one part of the building to another. Institutional corridors were broken down, splayed and widened and daylight brought in; social areas of seating were introduced; and the nurses’ stations are disposed to facilitate conversation.

From Inside the Walls The Director of Nursing in the HSE Child and Adolescent Psychiatric Unit in Cork, Michael A. O’Sullivan, tells us about his experiences of the building.

he young people have benefitted greatly from the design and overall space afforded to them through the extensive refurbishment and new build elements of the project. There are numerous areas that young people can relax in, take part in activities or simply meet with their family and friends, and these are softer and less clinical. The building does not fit with general perceptions of what a hospital environment should look like – it is very modern and contemporary. Greater privacy is afforded to the young people as each one now has an individual bedroom and en suite, and the bedroom area is separate to all daytime activity areas. Having a number of designated television rooms and games rooms helps the young people differentiate between structured programmes and down time. The development of a purpose-built kitchen and dining room allows greater food choice and display, while facilitating the young people and staff to dine in the one area. The provision of designated visiting rooms and areas as well as a parents flat/family room further enhances the service. Two separate garden areas also allow for greater privacy. Greater therapy spaces and multi-purpose rooms assist team meetings and staff development and training. Individual staff offices and staff rooms, as well as changing facilities, provide added value to all staff. The education service has moved from a single classroom setting to specially designed classrooms that comprise a school and recreational hall. This will allow an extensive development of subjects to include home economics, art, IT and physical education in rooms that are specifically designed with the subject matter in mind. Large elements of the service have unobstructed views of rural and agricultural life within an urban setting, which enhances the domestic feel overall.

The HSE’s award winning Child and Adolescent Psychiatric Unit in Merlin Park, Galway.

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Health Matters 13

estates storey residential units to the south nestle into the tree line, with the three-bed special care area of the adolescent unit in the most secluded and private corner, complete with private external space. Strong visual connections to the external environment have been carefully maintained through the use of heavily reinforced full-height glazing. This gives a continual sense of location throughout the day and eschews connotations of institution and enclosure.

The HSE’s award winning Child and Adolescent Psychiatric Unit in Merlin Park, Galway.

One of the Best roject architect Mícheál de Siún of Moloney O’Beirne architects tells Health Matters about the new Child and Adolescent Mental Health Unit in Merlin Park University Hospital, Galway which made the shortlist in the Best Health and Leisure category in the Irish Architecture Awards 2011. In January 2006, the Government officially launched ‘A Vision for Change’, a report of the Expert Group on Mental Health Policy. This report formed the basis for the new National Policy Framework for Mental Health Services in the State and was the first comprehensive review of mental health policy since ‘Planning for the Future’ was published in 1984. The provision of a new Child and Adolescent Mental Health (CAMH) Unit on the grounds of Merlin Park – the first of only two such purpose-built facilities in the State – is a key part of the implementation of these reforms for CAMH services in the West.

Maximising Therapeutic Potential Mental health suffers a historical stigma in Ireland, associated in a built context with Victorian-era asylums and medical institutions. The challenges in approaching a Mental Health Unit specifically designed to cater for children and adolescents are manifold. The design brief prepared by the HSE and St Anne’s User Group states that, “the overall environment [of the unit] is one aimed at maximising the therapeutic potential of all the experiences throughout

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“the overall environment is one aimed at maximising the therapeutic potential of all the experiences throughout the child’s day.” the child’s day and maintaining a homely, caring culture.” Of overriding concern is the safety of the child; a design must obviate potential points of ligature and minimise the potential of built elements that might allow residents to self harm. Materials and fittings must capable of withstanding deliberate and sustained attack, while any element that does fail or break must not present a risk to the child or afford them a weapon. The building must allow for staff to safely and discreetly monitor the children without infringing on their rights or dignity, and any external space must limit the potential for absconding and be easily observed by staff, while also protecting the children from intruders and unwanted attentions. In addition, a building must conform to the requirements of infection control standards, nursing regulation, and provision for secure drugs storage, and be cognisant of staff safety. The scheme is organised in four distinct buildings arranged within – and defining – a secure external area, dotted with play equipment, trees and benches. The single-

Conflicting Requirements The project ambition is to provide a mental health setting for children and adolescents free from the stigmas of institutionalised care, and offer an environment that is safe, homely, caring and therapeutic. The degree to which this ambition has been realised – with the requirements of open observable areas vying with a requirement for ‘cosy’, familiar and, essentially, private spaces – can only be fully assessed in time as the service grows into and personalises its new environment. Soft furnishings, curtains, glass, seasonal graphics and decoration, and other elements that adapt the space will all play their part in what this unit will mean to its residents. The feedback from the service as staff and children occupy the unit, and a continuing relationship with user groups and architects is crucial, as it is only when the building is occupied that it can become a living and evolving part of the CAMH service in the West.

Thanks and Praise Speaking about the success of the HSE buildings in the prestigious Irish Architecture Awards, the HSE’s Deputy Chief Architectural Advisor, Eleanor Masterson, said: “We are delighted that two HSE buildings are identified as award-winning projects […] It is encouraging for all those who have worked hard in the briefing, design and delivery of the projects to know that these are not only excellent clinical facilities but also ones of significant architectural design merit. Good quality architecture can help improve the experience of all who will work, use and visit these new facilities.”

08/12/2011 16:36:33

Excellence in Seating O’ Flynn Medical Ltd., in conjunction with Seating Matters are working together clinically to ensure client care is a holistic experience. Seating has now become part of the professional discipline and in recognition of this O’ Flynn Medical now employ an Occupational Therapist and Clinical Nurse Specialist full time to ensure quality care outcomes as well as enhancing the overall health experiences for clients and families.

The objectives of Seating Assessments are: Client comfort • Increased daily function and independence • Maintaining skin integrity • Providing postural support and alignment • To limit the adverse effects of muscle imbalance The O’ Flynn Medical Health Care Professional Team provide: • Formal client assessments • Trials of product range to suit individual clients • Sale and rental of bespoke clinical seating • Formal and informal education and training days • External clinical advise from Martina Tierney, OT Specialist and owner of the Seating Matters Range • After sales review assessments to maximise clinical input

The Seating Matters Range includes the Monoco, Atlanta, Sorrento and Phoenix which are all Irish made products. Individual clients differ, so having access to such an integral range of specialised comfort seating is a must in providing the holistic 24 hour care experiences.

For assessment, trial or to request a free copy of the Clinician’s Seating Handbook (Author Martina Tierney) (RRP £17.99), please contact: O’ Flynn Medical Ltd Locall: 1890 440440, email: info@oflynnmedical.com,

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08/12/2011 16:36:41

HealtH Matters 15

adVocacy

Volunteer advocates support 2,000 nurSing hoMe reSiDenTS More than 250 volunteer advocates in almost 100 nursing homes are assisting over 2,000 older people in residential care, who may not be able to speak for themselves or pursue their rights, according to anne harris, hSe Project Manager.

any of the volunteers in Irish nursing homes are providing a regular weekly service to older people under the advocacy Programme for Older People in residential Care. the programme is now the responsibility of third age, a voluntary community organisation working with older persons. It was developed in response to the recommendations made by the Forum on services for Older People. Many people have asked what exactly an advocate does and the role can be explained very simply by saying that an advocate listens to an older person and acts on their wishes. Issues that have been resolved by advocates include the very simple task of locating a person’s reading glasses (which had been sent for repair, ultimately denying the resident the ability to read her newspaper), to designing a garden so that residents might have a better view. advocates have been involved in other initiatives such as researching pension rights for people, tracing family members with which the older person has lost contact, and many other such issues. “Older people often will not complain even if they are unhappy or feel they cannot express their wishes,” says one volunteer advocate. the advocate in this instance could play a major part in ensuring that the voice of the older person is heard. However, in some instances the resident will not allow any intervention to be made on their behalf – perhaps because of fear of retribution! One of the advocates recently said, “I don’t achieve something of major significance with every resident or, indeed, at every visit, but when I make a real connection and can support someone in advocating for themselves, identify things that can help, or help implement positive changes that can improve life for a resident when I do make a difference, it is so rewarding’.

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my home From home the programme has established an independent website at www.myhomefromhome.ie. the website was designed to allow the public view information about most nursing homes in the country, on a county-bycounty basis, additionally enabling them to view the most recent Health Information and Quality authority’s Inspection report on those homes. the website gives much of the information required to choose a suitable home for a person’s specific needs. as the website becomes more widely known it is hoped it will provide an excellent resource for family members faced with the crisis situation of having to choose a care home to suit their dependent relative’s needs. the website should also provide a resource for healthcare professionals whose role it is to source and provide such a service. PersoN-CeNTreD Care the programme has also created a values-based educational intervention

designed to assist care staff to engage in Person-Centred Care: focus on the dignity, respect, health and safety of each individual resident; create a work environment that fosters innovation and change in support of Person-Centred Care; champion an organisational value of personal excellence and bring out the best in themselves through personal development. More than 300 staff members have participated in the values intervention training to date. these interventions culminated in a refocusing of staff attitudes towards the residents in their care, coupled with commitments to personal initiatives to live the values of personal excellence and compassion, and proposals to the management of initiatives that would facilitate embedding the values into the culture of the organisation. What this means to the resident is that staff members who have experienced ‘personal excellence training’ become committed to delivering care out of their own humanity and compassion and not just ‘as a job’.

anne Harris, Hse Project Manager, National advocacy Programme; elaine O’Donovan, advocate; Greg Price, Hse Director of advocacy; Marguerite Good, advocate; and Helen Mackessy, advocate.

08/12/2011 16:36:46

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abcd HM Iss7.4 p1-32.indd 16

08/12/2011 16:36:50

HealtH Matters 17

campaIgn

Are you ThinKing ABouT QuiTTing? Dr José ayala, health Promotion Service, hSe Dublin Mid leinster, gives his best advice on how to stop smoking.

o, you’ve decided to quit smoking. How do you go about it? Firstly, do a quick ‘motivations’ check on yourself. Why do you want to quit? Is it for health reasons? For your kids? to save money? to not feel guilty about smoking? to get back some control you feel has been lost to cigarettes? You probably have one or more of these reasons in mind, which can help to focus your efforts. Next: How will you quit? a simple checklist could include the following:

ThiNk abouT your habiTs aND FiND alTerNaTives Using a diary to log your smoking patterns and triggers can help you to start looking at how you’re going to deal with them as a nonsmoker. If stress is a major trigger, remember that everyone has some kind of stress and needs to deal with it somehow – even non-

smokers. talk to someone you trust. Increasing your physical activity levels, starting a DIY project, or taking on a new hobby can help to keep your mind and body distracted in a positive way. Before your quit date, consider setting up smoke-free zones where you live or in the car. a conscious decision not to smoke in these places will help to break the unconscious associations you’ve built up over years of smoking.

seT a QuiT DaTe there’s never a perfect date, but sooner is better than later. treat yourself on this day, if at all possible. then get rid of all the cigarettes, lighters, ash trays, etc. and make a clean start. PrePare For CraviNgs aND WiThDraWals You’re likely to experience both physical cravings and withdrawal symptoms, and using treatments such as nicotine replacement therapy (patch, gum, lozenge, microtab, or inhaler), Champix or Zyban can double your chance of success. Make use of your local smoking cessation services, too, which can be found on the Quit.ie website or via the National smokers’ Quitline (1850 201 203).

Pictured is Pauline Bell (with Dr Fenton Howell, Hse) whose story features in the Hse’s new QUIt campaign television ads.

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Take oNe Day aT a Time take it one craving at a time in the beginning. remember that the

more time you put between yourself and that cigarette is an accomplishment of its own.

use The Four Ds to help deal with the cravings: • Delay (cravings should last only three to five minutes) • Distract (try a change of venue or activity) • Deep breathing (a few relaxing breaths) • Drink water (no calories and a healthy hand-to-mouth replacement habit) sTay PosiTive the bottom line is that you can quit. stay positive and keep trying! Get support if you have to. remember that one in every two smokers will die of a smoking-related disease, so quitting now instead of later will help you beat this stark fact. For more information on supports available in your area and to sign up for a personalised quit plan, visit www.quit.ie, join us on www.facebook.com/Hsequit, or call the National smokers’ Quitline on loCall 1850 201 203. NeW QuiT aDs oN our sCreeNs In November, the Hse began broadcasting a new QUIt campaign television advert and online film that exposes the sad reality of losing a loved one to a tobacco-related disease. since its launch in June of this year, the QUIt campaign has focused on one key fact – that one in every two smokers will die of a tobacco-related disease. these adverts use real people to bring that fact to life, in the words of those left behind. Pauline Bell from Wexford is a mother of two. three years ago, her husband George died from a heart attack at 48 years of age. He was a heavy smoker. Pauline has volunteered to tell her and George’s story in the hope that it will inspire others to quit – for their own health, and to prevent other families experiencing what hers has been through.

08/12/2011 16:37:00

18 Health Matters

commercial feature Controlling high blood pressure in community based care. Health Research Board funded study examines how patient self-management and organised follow up can help reduce high blood pressure

hronically high blood pressure, or hypertension, can lead to serious medical problems such as heart disease and stroke - so keeping blood Dr Liam Glynn pressure under control is an important public health issue. However despite this, only 25-40 per cent of patients who take anti-hypertensive drug treatment manage to achieve their blood pressure goals. Now a study funded by the Health Research Board has identified practices

in community-based care that could help tackle the problem. The research is one of over 40 projects highlighted in the Health Research Board’s annual Picture of Health 2011 publication. Launched on Thursday December 1st, the HRB Picture of Health communicates the findings of recently funded research to a general audience. One of the studies included in this year’s publication is a HRB-funded Cochrane review study led by Dr Liam Glynn. The research analysed 72 randomised controlled trials in the published literature that looked at dealing with hypertension in the communitycare setting. Overall, the review found that education aimed at patients or healthcare professionals does not appear to be effective - what works best is good organisation that sees

patients regularly followed up and recalled for appointments. Other strategies for success encourage patients to monitor their own blood pressure or involve other health professionals such as nurses and pharmacists in blood pressure management in the community. ‘It has direct translation to everyday clinical practice,’ says Dr Glynn, a Senior Lecturer in General Practice at NUI Galway and GP in Ballyvaughan, Co. Clare. ‘We need to improve organisation in terms of diagnosing, treating and following up patients with hypertension; and that can include nurseled care, the use of technology such as text messages to remind patients to take their medication or come to appointments ,and also getting patients more involved in the monitoring of their own illness.’

PICTUR

PICTURE OF HEALTH

OF HEALT

A snapshot of HRB funded research

A snapshot of HRB fu

The Picture of Health 2011 report describes, in easily understood language, the latest developments in health research supported by the Health Research Board (HRB). This year’s edition shows the active involvement of dentists, doctors, midwives, nurses, physiotherapists, psychologists, social workers, statisticians, and others in Irish health research, alongside the more traditional academic researchers. www.hrb.ie

Publication available from 1st December 2011 Keep in touch with the HRB: www.hrb.ie www.twitter.com/hrbireland www.facebook.com/hrbireland http://www.hrb.ie/about/rss-e-mail-alerts Better Research • Better Evidence • Better Services • Better Care

HM Iss7.4 p1-32.indd 18

08/12/2011 16:37:02

Health Matters 19

cystic fibrosis

President opens Cystic Fibrosis Unit at Crumlin Hospital In October, the then President of Ireland, Mary McAleese, opened the Cystic Fibrosis In-Patient Facility at Our Lady’s Children’s Hospital, helping to deliver state-of-the-art to care to CF patients, in line with international standards.

he new Cystic Fibrosis In-Patient Facility at Our Lady’s Children’s Hospital, Crumlin facility provides four single isolation rooms with en suite facilities, a parent’s lounge, and a pull-down bed and TV and entertainment systems in each room. Internationally, the standard of care is that in-patients with CF are cared for in isolation and the new rooms that have been added to St Michael’s Ward are specialised isolation rooms that enable the hospital to reduce the spread of harmful bacteria between patients. Speaking at the launch, Dr Paul McNally, Director of Respiratory Medicine at the hospital, said: “The planning and design of this unit has been going on for several years and many people have been involved in this process. The funding for this unit came entirely from charitable donations from the Cystic Fibrosis Association of Ireland and the Children’s Medical & Research Foundation. To these groups we are enormously grateful.” Also speaking at the launch, the CEO of the Cystic Fibrosis Association of Ireland (CFAI), Philip Watt, stated: “The new CF rooms and the major upgrading of St Michael’s Ward have made a fantastic difference for children and young people with CF in Crumlin Hospital. Parents have been contacting us to let us know how pleased they are with the development, which significantly reduces the risk of cross infection.” “These new rooms for cystic fibrosis patients really are something else,” said Bevin Murphy, a patient. “I would be in and out of hospital about four or five times a year, for two weeks at a time, and they make my stay in hospital so much easier. It’s almost like staying in the Presidential Suite! They are bright and spacious with flat-screen TVs, games consoles and, best of all, are the en suite toilet facilities, which are extremely important. All the rooms have pull-out beds for our parents, which is great as usually our parents have to sleep on

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Catholic Archbishop of Dublin Diarmuid Martin accompanies President McAleese as she officially opened Crumlin Hospital’s Cystic Fibrosis in-patient facility.

mattresses on the floor.” The total cost of the project was s1.4 million, all of which was raised through donor support and corporate partnerships.

New ward block for St Vincent’s Hospital

Construction of a new ward block at St Vincent’s University Hospital in Dublin, is expected to be completed next Spring.The new development will replace existing bed capacity and a specialist unit will provide 100 single en suite rooms to accommodate cystic fibrosis, liver disease, oncology and other specialties. It will also provide ancillary support accommodation, including a 10-bedded day unit for patients with cystic fibrosis. The development will make a major contribution to improving patient care. It will accommodate patients whose medical requirements necessitate single en suite facilities and will reflect best practice in terms of infection control.

Newborn Screening Since July, the National Newborn Bloodspot Screening Programme, or ‘heel prick’ test, which screens all newborn babies for a range of rare inherited conditions, includes a test for cystic fibrosis. The screening test is done within the first five days of birth, usually at home by the Public Health Nurse. Ireland has a high incidence of CF compared to other EU countries and early identification and care is of great benefit to children with CF. Dr Kevin Kelleher, Head of Health Protection and Child Health, HSE, welcomed the change: “Screening for cystic fibrosis, along with the existing five conditions, aids early detection and helps babies to begin treatment as soon as possible. While these conditions are all rare, it’s very important that parents have their baby screened.” For more information on this programme, visit www.newbornscreening.ie.

08/12/2011 16:37:04

20 Health Matters

radiology

Roll-out of National Integrated Medical Imaging System gathers pace In previous articles in Health Matters, Prof. Neil O’Hare (NIMIS Project Lead) outlined the background to the project and the benefits that will emanate from its installation. In this article, he gives an update on the project and its successes to date.

©istockphoto.com/haydenbird

icture Archive and Communication Systems (PACS) are a method of digitally storing images from all radiology imaging devices to enable convenient access for relevant members of hospital staff. Radiology Information Systems (RIS) are IT systems that manage the patient bookings, workflows and reports throughout radiology. This, in practice, means that a patient’s imaging information and their reports are available to any clinician from any computer throughout the clinical areas of the hospital. Four hospitals – Sligo General, Waterford Regional and both Beaumont and the Mater in Dublin – are now live with the system and, by year end, the number will have risen to nine with five hospitals in the north east region taking up the service.

Rapid Installation A huge amount of work has been undertaken by the local NIMIS teams, the national team, the main supplier (McKesson) and other suppliers, and HSE employees to bring the project to the point where we are now in a rapid implementation phase with, on average, two hospitals going live with the system each month. To achieve the rapid installations of the system it was essential that the HSE streamlined and harmonised a range of processes and workflows. Relatively simple aspects like the names for each radiology investigation and how system users were

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08/12/2011 16:37:09

Health Matters 21

radiology

©istockphoto.com/Paha_L

identified had to be standardised. The NIMIS project took the opportunity to ensure such standardisation fitted into the requirements of other healthcare-related ICT projects. The development of such standards has had the added benefit of bringing these teams from across the country together and has aided collaboration. Towards the end of 2010, the main servers and data storage systems were installed in the HSE’s Data Centre in Clonshaugh, Dublin. This enabled the sites to start configuring and testing the system. Work also commenced with Healthlink to develop a method of ensuring GPs received the radiology reports for their patients electronically, removing the need to print and send reports via the postal service.

“With NIMIS, all the hospital’s patient radiology images and reports are available to not only to the clinical staff in the hospital, but also to clinical staff in other hospitals where necessary.”

Going Live The first go-live in Sligo in June of this year was a success and proved that all the hard work had paid off. However, with the go-live in Beaumont Hospital in August, the real benefits of such an integrated national system started to emerge. With NIMIS, all the hospital’s patient radiology images and reports are available to not only to the clinical staff in the hospital, but also to clinical staff in other hospitals where necessary. An additional feature of the system is the capability to capture, display and report on patient ECGs. In a similar way to images, these are available throughout the hospital and further afield if the patient is referred onwards for further investigations or treatment.

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The NIMIS project is now providing real patient benefits and efficiencies in those hospitals where it is live. The system provides capabilities and tools to the clinical staff heretofore not available, or only available on stand-alone computers. This includes electronic ordering for imaging procedures; voice recognition for the rapid generation of radiology reports; high-end 3D processing capabilities to help Radiologists, Surgeons and others to report on diagnostic tests, or assist in surgical planning; cross-site reporting capabilities; and the rapid provision of radiology reports to clinical staff and General Practitioners. As the hospitals become more familiar with the system, even greater benefits and advantages should emerge.

NIMIS Case Study: Beaumont Hospital Within days of the system going live, NIMIS eased the care pathway for many patients from the first two hospitals, Sligo General and Beaumont. For example, a Radiologist based in Sligo was able to receive a second opinion from a Beaumont NeuroRadiologist. Having made a quick phone call, the image was reviewed and reported on within minutes, and the second opinion was recorded on the system and became part of the patient record. In another example, staff at Beaumont have benefited from the instant availability of images and reports for Sligo patients who are transferred into their care, thereby reducing the requirement to take further images in Beaumont Hospital.

Film-Free The scale of the Beaumont NIMIS project shouldn’t be underestimated. Fulfilling the objective of becoming filmless and paperlight overnight was certainly no simple task. Many hospitals throughout the country and across the world have already installed their second and third-generation PACS system. The move from conventional film into the digital world, however, is a bigger leap and this is what has been achieved at Beaumont. In doing so, a number of challenges had to be addressed. For example, nearly every process that involved radiology in Beaumont pre-PACS had either paper cards or X-ray film as the driving force and, as the project had adopted a ‘Big Bang’ implementation, the switch to a filmless, paper-light system presented a major challenge. training With over 2,000 people to be trained on the system, a carefully planned approach to training was essential. Outside the Radiology Department there were significant changes also. Primarily, the switch from paper orders to electronic ordering of radiology investigations from the Out-patient Department which presented a substantial undertaking. Without doubt the most striking benefit realised is the decrease in report turnaround time (TAT). TAT within four weeks of the implementation of the system has decreased, with all reports now having a TAT of less than 18 hours. This is a figure which would have been nearly impossible to achieve in the film-based environment.

08/12/2011 16:37:11

22 HealtH Matters

“

feature

infAnT iMAginingS Music, performance and play bring joy to Parent and Toddler groups in Sligo and leitrim.

abies, toddlers and their families attending the Hse early Intervention service in sligo and leitrim are discovering how music and rhyme can be brought to life through creative play. since March this year, the early Intervention service has been collaborating with Helium, a children’s arts and health company, on a unique arts initiative called Infant Imaginings for two Parent and toddler Groups. From March to June, the programme ran with a Parent and toddler Group in sligo and eight children and their parents participated, along with members of the early Intervention team including Counsellors for special Needs, Physiotherapists, Occupational therapists, speech and language therapists and the team Manager. the programme is now running from september to December with up to ten children and their parents with a Parent and toddler Group in leitrim. the Parent and toddler Groups, set up by the Hse Counsellor for special Needs service and parents of children with special needs, are support groups for families with babies and toddlers who are attending the Hse early Intervention teams. the Infant Imaginings project is being delivered by two professional performing artists, Helene Hugel, a puppeteer and artistic Director of Helium, and sean Callagy, a musician. the goal of the project is to promote relaxation, communication and learning between babies, toddlers and their parents through music, performance, puppetry and the visual arts. the Helium performing artists work with fabric, feathers, paper and other everyday materials to explore how very young children benefit from music, sound, and object play. a key focus of Infant Imaginings is to develop arts experiences that parents can reproduce in the home environment.

a NeW aPProaCh Kate Ferguson, early Intervention team Manager, explains how Infant Imaginings has benefitted the children and their

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‘Fun with fabric’ at the Parent and toddler Group in sligo during the summer. + ‘Bringing nursery rhymes to life’ at the Parent and toddler Group in sligo during the summer.

parents taking part. she says: “the early Intervention teams provide multidisciplinary services to children with developmental delay, or children who are at risk of developmental delay, in the nought to six-year age group. the teams work with parents/guardians on their journey through assessment, diagnosis and intervention, to enable each child to reach their potential. “the children we see have different abilities and the emphasis of the project is on providing creative play experiences for toddlers,” she adds. “the performance artists have different ways, different ideas and different creative skills that we might not necessarily have as therapists and clinicians, and the balance is very good. It gives a more holistic approach to the children.” Both performance artists leave behind a kit of props, puppets and sean’s acoustic CD of nursery rhymes to facilitate the group in reproducing the experiences and activities explored in the future. Overall,

the project promotes learning and sharing of ideas between collaborating artists, healthcare staff and parents. For further information on this initiative please email kate.ferguson@hse.ie.

FeeDbaCk From PareNTs “Very impressed with the way music has been brought to life through play. the children loved every minute of it and were encouraged to explore the different instruments.” “I found the Helium sessions excellent. It was presented in such a manner that my daughter could interact when she felt ready to; it was non-threatening. My daughter loves music – and it is such a good medium for communication.”

08/12/2011 16:37:24

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07/12/2011 12:55 08/12/2011 16:37:24

24 Health Matters

community nursing

TV Series to focus on nursing in the community A new television series to be broadcast on RTÉ One in the New Year will focus on the role of Public Health Nurses in Ireland. Six Nurses working in communities around the country will feature in the series, which has been made for RTÉ by GMarshTV Productions.

ommunity and Public Health Nurses make almost 10,000 house calls every day in every corner of Ireland and a new series coming to RTÉ One follows six of them as they go about their work, which includes caring for new mothers, patients recently discharged from hospital, people with a chronic illness or wounds needing attention, and the elderly. Community Nurses quietly go about their work and are rarely in the limelight. This new series will give the public a rare insight into the work they do and the dedication and commitment they give to the job. Filming for The Nurse began in September of last year and concluded last summer. The six Public Health Nurses who participated in the series were Mary Walsh, Kathleen Gilheaney, John Carew, Sheila Clancy, Helen Coyne and Kirsten Priesler. The original idea for the series came from Mary O’Dowd from the Institute of Community Health Nursing and the programme makers were facilitated by the HSE’s Communications Directorate.

PHNs Across the Country The programme makers wanted to feature a cross-section of Nurses working in different communities in different parts of the country. Mary was filmed working with people on Inishbofin Island off the coast of Connemara in Co. Galway. Kathleen works in Swanlinbar in rural Cavan, while Helen and Kirsten both operate in the north Dublin city area of Coolock. John is based in suburban Castleknock in Dublin and is one of only a small number of male Public Health Nurses. Sheila is based in Kilkee, Co. Clare. “We wanted to get a real sense of what Public Health Nurses do. In order to tell the story it was necessary to get a spread of

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different nurses from different locations,” said Mairead Tucker, the producer with GmarshTV Productions. “Most people in the general public are unaware of the amazing work done by Public Health Nurses,” she continues. PHNs care for the community from cradle to grave. Every newborn baby in the country will be visited in its first week by a PHN; they care for the elderly and isolated in our community, tend to wound care, child health and everything in between.”

“We wanted to get a real sense of what Public Health Nurses do. In order to tell the story it was necessary to get a spread of different nurses from different locations.”

Highlighting Extraordinary Work The Nurses featured in the programme give a real insight into the Ireland of today. The patients have wonderful relationships with the Nurses and, through them, we get to meet lovely people who graciously tell their stories. “Our community nurses go quietly about their business every day, and yet what they achieve is extraordinary,” adds Mairead. There are 1,555 staff working as

Public Health Nurses in the HSE and this programme shows how they work as members of Primary Care Teams, helping to maximise the potential of community-based health professionals. To find out more about The Nurse, search for ‘The Nurse RTÉ’ on Facebook.

Meet the Nurses Kathleen Gilheaney trained in Armagh during the height of the Troubles. As a result, no wound will ever faze her. Kathleen has been the Community Nurse in the border community of Swanlinbar in Co. Cavan for ten years. “Knocking on a door isn’t enough; if you don’t get a reply you still have to find out why,” she says. “You see people as they really are, when they are at their most vulnerable. But we must always be aware that we are the visitor in the home and sometimes the only visitor they might have that day, or even that week.” Revealing why she decided to take part in the show, Kathleen adds: “From a professional point of view, I was glad to be able to show that even in the most rural locations we have Primary Care Teams who assess and implement care plans according to the patient’s needs.” John Carew is based in the leafy suburb of Castleknock in Dublin, is one of the country’s few male nurses, and has to deal with people’s reactions to his chosen profession as well as a very heavy caseload. “A large proportion of our job is support and being an advocate for the people we care for,” he says. “We are the link between the various agencies, Social Workers, GPs, Physiotherapists and Carers, Without us, patients might not know how to access these services.”

08/12/2011 16:37:24

Health Matters 25

community nursing “I am really proud to have been a part of this documentary as it highlights the day-to-day work of the Public Health Nurse, and I hope the public will enjoy it.” +

Sheila Clancy

Mary Walsh

John Carew

Helen Coyne has been a Community Nurse in Coolock, north Dublin, for the past ten years, and it was the only job she ever wanted to do. “I can honestly say in all the years I’ve been a nurse, I’ve always wanted to go to work in the morning. I love making a difference, and being able to make a difference,” she says. “I am really proud to have been a part of this documentary as it highlights the day-today work of the Public Health Nurse, and I hope the public will enjoy it.” Kirsten Preisler is also based in Coolock and has been a Public Health Nurse there for five years. A new mother herself, she is more than aware of the pressures of childcare and raising a family: “It’s good to be able to relate to new mothers and say, ‘Don’t worry, it’s normal.’ I’ve been there as well, I’ve been through the sleepless nights.” Initially, Kirsten found it daunting to have a camera crew following her around in the car and during work. However, after the initial nerves settled, filming became routine and part of her day’s work. “I enjoyed this challenge,” she says. “The clients who participated were delighted with the experience, and identified the dedication of the Nurse in her daily work.” Sheila Clancy has been the Public Health Nurse in the Clare resort town of Kilkee for ten years. She can make up to 15 house calls a day, seeing every aliment and every age: “As a Public Health Nurse, you’re visiting a home, a family and the network that goes with all of that. You get a unique insight into the supports that keep a community together.”

HM Iss7.4 p1-32.indd 25

Speaking about her participation, she adds: “It was very enjoyable but quite daunting in some respects, and I didn’t anticipate just how much hard work would be involved. My husband and children say they can’t wait to see it on air.”

Mary Walsh was the Public Health Nurse on Inishbofin for four years. When on the island,

she was on duty 24 hours a day, seven days a week. “The islanders were my patients and I was the Nurse, and that was it,” she says. “It was completely different to mainland nursing or hospital nursing; if there was an emergency there was no hospital just around the corner. I was on my own, relying on the boat or the helicopter to get my patients off the island. They were my back-up.”

08/12/2011 16:37:29

26 HealtH Matters

dIsabIlIty

ChAllenging TiMeS for BlinD ADVenTurer less than a year after he became the first blind person to reach the South Pole, Mark Pollock was in a devastating accident in england. in July 2010, he fell from a secondﬂoor window. The fall left him paralysed and in a wheelchair. here he tells laura Monaghan why he is hopeful about the future.

lind adventure athlete and motivational speaker Mark Pollock is goal-driven. the 34-year-old from Holywood, Co Down has successfully completed extreme challenges in places like the Gobi desert, the Himalayas and the North Pole. In 2009 Mark was one of a team of three who successfully competed in a race to the south Pole, one of the harshest environments in the world. Mark, who went fully blind at the age of 22 years when his retinas became detached, is currently facing what is probably the biggest challenge of his life so far. less than a year after he became the first blind person to reach the south Pole in 2009, he was in a devastating accident. In July 2010 he fell from a second-floor window. the fall left him paralysed and in a wheelchair. Mark recently left the National rehabilitation Hospital in Dun laoghaire where he’s had eight months of rehabilitation treatment. after his fall he was treated for a number of months in the stoke Mandeville Hospital in england before being moved from there to the National rehabilitation Hospital.

HM Iss7.4 p1-32.indd 26

Defeatist words like ‘can’t or failure’ don’t seem to be in his vocabulary which is why he was an inspired choice to present a new reality television series on setanta sports. the tV series ‘Yes I Can’, which was broadcast in November and December, showed people with disabilities overcoming their fears and attempting an extreme sport.

NeW ChalleNges On why he thinks it’s important to keep setting new challenges and goals, Mark says: ‘‘In my case I do all my adventures for my own reasons, to challenge myself,

to push myself, to explore the possibility, to see what happens when you come to the edge of failure and then you push on and go on to achieve your goals. I think it was the same in the programme. I think people were testing themselves and trying to achieve something that they really wanted to. I think the spin-off is perhaps people who are watching can gain something from that and perhaps it inspires other people to have a go and take on their own challenges. I don’t think anyone in the programme was saying ‘Hey, if you’ve got X disability, you should

08/12/2011 16:37:44

Health Matters 27

disability be out doing Y challenge’. They were all doing the challenges for their own reasons but I suppose overall it’s a demonstration that people do set goals, they do doubt themselves, they do risk failure but they can at least have a go and at least have a try. So I don’t think the success of the challenge is the important part necessarily, having a go is the important part.’’

Dark days Mark is hopeful about the future but he admits there have been some dark days. ‘‘While I was going through the critical phase in England and multiple infections – I couldn’t really see any future. When I got back to Ireland I went from periods of feeling there was some kind of future to having periods where I felt I was never going to get out of hospital. My whole time in England I was very, very sick and I just felt like I kept getting knocked back. There was an improvement when I got here. In Dun Laoghaire I eventually started to feel a bit institutionalised and I didn’t feel like I was ever going to get out and that was tough and difficult.’’ Goals Describing how he usually sets and works towards goals Mark explains: ‘‘Usually what I would do is look where I am at any given time, try to deal in the facts of what’s happening and then I try to come up with a plan and work towards that. The difficulty with this whole time in England and in Ireland is that some of the stuff which would allow me to progress with the rest of my life was slightly outside my control. I couldn’t leave hospital until I had various supports in place so a lot of the stuff was contrary to how I normally deal with challenges. Normally I look at where I am as a starting point, look at what the end point is or what the goal is and then I try and actively work towards that goal and most of the things are within my sphere of influence. It was difficult and unusual for me to have so much that was outside my control. I think that’s probably the aspect that I found most difficult.’’ Project Walk Mark is determined to regain as much mobility as he can and to support him in his objective he has signed up for a rehabilitation programme in California called Project Walk. He describes the training involved as being similar to how he

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+ Mark on his expedition to the south pole. Image courtesy of www.extremeworldraces.com

would have trained for his South Pole or Gobi Desert races or for rowing. He was a champion schools rower and captain of the university’s rowing club when he attended Trinity College. ‘‘It’s based on sports principles and it’s a spinal injuries gym. It takes the level that you would train at for sport and this is where I can see the link. Now I don’t have access to that all of the time but whenever I was over in California I was able to do that. I’m training the paralyzed parts of my body with a view to, a sliding scale of goals. ‘‘At the bare minimum it’s to keep circulation going and to keep my bones

“His aspirational goal is to regain the ability to walk, whether through medical or technological intervention, and he endeavours to stay in good shape in order to be ready for whatever advances come down the line.”

strong, avoid pressure sores and hopefully, stay out of hospital. That’s my basic aim, never to go back into hospital, and then my ultimate goal is to try and get some feeling and function back. "My aspiration is to walk again under my own steam, whether that’s with medical intervention or technological intervention. I think I have to stay in good shape in order to be ready for any advances that come down the line. I’m not saying everyone with a spinal injury should do a Project Walk progressive therapy programme. It’s how I am perhaps dealing with my spinal injury at the moment. It’s a natural fit for me, it allows me to train the way I did when I was training for the Gobi Desert run. It fits for me. I’m not saying everyone should do it."

Motivational speaking Before his accident Mark inspired thousands of leaders, managers and teams around the world with his motivational speeches. He’s adamant it’s something he wants to go back doing. ‘‘I definitely would like to do that again. It all fits in with getting life back on track. I certainly do want to go back speaking. I probably want to go back adventuring again and I was in the middle of writing another book when I had my accident so I suppose what I’m doing at the moment is trying to work out what I’ve learnt from dealing with the whole accident and how that might be of interest to the audiences that I speak to. I certainly want to work again. Life’s not over because I’m now paralysed.’’

08/12/2011 16:37:45

28 Health Matters

clinical programmes

HSE’s First Nurse and Midwife Prescribing Conference A special conference was held recently to mark four years of nurse and midwife prescribing on the Irish health service.

he HSE’s first Nurse and Midwife Prescribing Conference was attended by 200 delegates and speakers from Ireland, the UK and Germany. The conference, held in November at the Royal College of Physicians Ireland, provided an opportunity for all key stakeholders involved to meet, network and share experiences and best practices. Since primary legislation was introduced four years ago, 354 Nurses and Midwives throughout the country are registered with An Bord Altranais as Registered Nurse and Midwife Prescribers and are actively prescribing medicinal products in varying healthcare areas. Over 100 nurses have also completed the required education programmes for ionising radiation (X-ray) prescribing.

“Nurses and Midwives now prescribe medicinal products and X-rays in both acute hospitals and in community settings in every county across the country.” Four Years of Success The conference was opened by Dr Siobhan O’Halloran, Assistant National Director, Acute Hospital Services, HSE. In her previous role as the Office of Nursing and Midwifery Services Director, Dr O’Halloran was instrumental in leading the introduction and implementation of this initiative. She said: “The prescribing initiative is first and

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(L-R) Rose Lorenz and Annette Cuddy, HSE Assistant Directors of Nursing and Midwifery.

foremost about patients and about how we as Nurses and Midwives in the HSE provide care. I am pleased to tell you that in this four-year period, Nurses and Midwives have written 57,399 prescriptions for 44,768 patients involving 88,927 medicinal products.” Michael Shannon, Director of the Office of Nursing and Midwifery Services, is delighted with the success of this initiative. Speaking at the close of the conference, he stated: “This conference marks the culmination of four years of a very successful process. Nurses and Midwives now prescribe medicinal products and X-rays in both acute hospitals and in community settings in every county across the country. This has had recognised benefits for patients and clients. Evidence shows that patients in Ireland are highly supportive and accepting of Nurse and Midwife prescribing as it reduces waiting times and facilitates patients accessing treatment that previously would have required longer waiting times.”

A Prescription for Practice A variety of presentations were given by both national and international experts. Topics included clinical governance, experiences of Registered Nurse Prescribers, professional regulation, collaboration, and the international experience of Nurse and Midwife prescribing. Also during the event, the Department of Health’s Chief Nurse, Sheila O’ Malley, launched a DVD titled Nurse and Midwife Prescribing: A Prescription for Practice. In her address, O’Malley said: “I am delighted to launch this DVD on Nurse and Midwife prescribing. I know this will support any organisation that is introducing or planning to introduce Nurse and Midwife prescribing. The focus of the DVD is to outline the benefits of prescribing and the essential elements of successful implementation.” To obtain copies, contact Hugh O'Neill on (01) 635 2323.

08/12/2011 16:37:48

HealtH Matters 29

your storIes

going To eXTreMeS Diana hogan Murphy, Antimicrobial Pharmacist with the Cavan and Monaghan hospital group, was the first person to complete an extreme multi-day endurance ultra-marathon on all seven continents, and also won the 250km Antarctica ultra-marathon in 2010. She tells health Matters about running in some of the most extreme conditions in the world.

y journey started in 2008 when I completed the Marathon de sables in the sahara Desert and finished when I won the last Desert 250km race in antarctica in November 2010. the first leg of the trip to antarctica began when I flew from Dublin to Buenos aires via Paris, to Ushuaia, southern argentina, the travel time was 26 hours. We then boarded ‘the arctic Dream’ bound for the frozen continent, a 70-hour journey across the Drake Passage, which is one of the most treacherous causeways on earth. as the ice-reinforced vessel swayed heavily and crashed back and forth into the 20-foot waves, we managed a few glances outside to view the spectacular humpback whales, orcas, penguins, crab-eating seals, albatrosses and giant petrels. this was only the beginning of the stunning views as the course was set in King George Island, Deception Island and Dorian Bay.

exTreme CoNDiTioNs the last Desert is an invitation-only 250km race open to those who have completed at least two other 250km selfsufficient racing the Planet events. a total of 56 people competed from 22 different countries. antarctica is the coldest, driest and windiest place on earth. Because the temperature as low as -70°C receives much of the attention, the katabatic winds are sometimes overlooked. routinely, they gust to near-hurricane strength and so the race directors and competitors were always unsure what the course route or time limit would be per stage. It was different from all the other multi-day races where competitors run from one point to the next covering up to 100km in any given day in the fastest time possible. Here, we were informed most mornings that the stage that day would

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consist of a 15-hour run and to cover as much distance as possible. In reality, that time varied from one hour to 11 hours daily due to the extremely unpredictable weather conditions, and, mostly, competitors had to run in a 2.5km loop for safety reasons in case of immediate evacuation off the island, which did occur once.

NaTure’s WoNDers the beauty of running past numerous penguin rookeries, floating turquoise iceberg formations, huge frozen glaciers, and even an active volcano and an avalanche is simply amazing. right of way of 50m is given to any of the wildlife in this part of the world so it was standard practice for us to wait patiently for Gentoo and adelie penguins or crab-eating seals to cross our paths! after five days of running in untouched whiteness, we

finished in the stunning shetland Island of Dorian Bay to the cheer of a flock of snow petrels. total journey: 12 days. Completing the seven continents dream has been gruelling, arduous and incredibly rewarding. the beauty and freedom of visiting these unspoiled, barely-known lands, as well as the physical and mental strength required to compete day-after-day with battered feet, minimum calorie intake and intense weather conditions, are what appeals to me and inspires me. equally special are the extraordinary fellow competitors and the unique camaraderie and fun between all. Whilst it is difficult to compare the different races and experiences – from areas such as the Gobi Desert in western China, to the Kimberleys in north west australia, to acatama Desert in north Chile – undoubtedly, antarctica is the most spectacular place I have ever visited.

08/12/2011 16:38:18

30 Health Matters

data protection

Data Protection – the responsibility of all HSE staff The HSE is legally required under the Data Protection Acts of 1988 and 2003 to ensure the security and confidentiality of all personal information / data it collects and processes on behalf of its clients, patients and employees.

he Data Protection Acts set out key principles in relation to the protection of personal data. Personal data collected by staff in the HSE in the normal course of work must be: obtained and processed fairly, kept for one or more specified, explicit and lawful purposes: used and disclosed only in ways compatible with these purposes: kept safe and secure: kept accurate, complete and up-to date: adequate, relevant and not excessive: retained for no longer than is necessary for the purpose or purposes for which it was collected and a copy given to the individual of his / her personal data on request. The HSE is currently reviewing its strategic and operational approach to data protection which includes reviewing our policies and procedures. In the interim the current policies which are available on the Intranet should continue to be followed. The following sets out some overall practical steps HSE staff can take to ensure we uphold the principles of the Data Protection Acts and ensure the protection of personal records and avoid data protection breach incidents.

Practical steps for HSE Staff to ensure data protection standards are upheld and data breaches are avoided. • Only use HSE supported encrypted and provided mobile electronic equipment (i.e. Laptop, Blackberry, mobile phone etc). • The storage (temporary or long term) of confidential or personal information (encrypted or otherwise) on USB flash drives (i.e. memory stick/pen/keys) is strictly prohibited. • Care should be taken to ensure that personal information / data is not

HM Iss7.4 p1-32.indd 30

deliberately or inadvertently viewed by uninvolved individuals (e.g. computer screens on view, files left on desks). •P ersonal information / data that has to be taken from the office as part of staff duties or electronic equipment such as laptops should be securely stored in the boot of the car. •F iles containing personal information should be stored in a locked filing cabinet when not being used. •C are should be taken to ensure the security of filing cabinet keys. • A “clear desk” policy should be maintained at the end of each working day or when on necessary long periods of absence away from the desk / work station / office. • I t is preferable that post rather than fax or email is used for correspondence concerning personal information. When it is necessary to use either fax or email the HSE’s electronic communications policy must be adhered to. •W hen posting personal information, ensure the correct size envelope is used to prevent it from tearing and ensure the envelope is securely sealed. “Personal and Confidential” should be printed on the outside. •F ax numbers which are used on a regular basis should be pre-programmed to help avoid an incorrect number. • When sending an email double check the contact details are correct, problems have been encountered by selecting an incorrect recipient from an address list or with similar but incorrect contact details. •W hen sending an email attachment, double check to verify the correct attachment is sent. • The HSE’s encryption policy must be strictly adhered to regarding desktop computers, mobile computer devices and

“The HSE is currently reviewing its strategic and operational approach to data protection which includes reviewing our policies and procedures.” removable storage devices. • Passwords should not be shared amongst colleagues. Passwords should not be written down and left in accessible places e.g. on or near your desktop or laptop. Passwords should be changed at regular intervals. Log out or lock your desktop / laptop when not at your desk, also use screen saver and password. Users must only use accounts and passwords that are assigned to them, the HSE’s passwords standards policy must be adhered to. • When photocopying ensure copies are not left on or around the photocopier. • Office Photocopiers or fax machines should not be located in a public area. • Paper records when authorized for destruction must be disposed of by shredding and the shredded paper must only be stored for collection and removal in the specific HSE supplied bag provided for that purpose (domestic waste bags must not be used to store shredded paper). • Confidential patient / service user personal information should not be discussed with the patient/service user or with colleagues in any setting where patient confidentiality may be breached.

08/12/2011 16:38:18

HealtH Matters 31

data protectIon â&#x20AC;˘ report any breach incident to your line supervisor / manager. this set of practical steps is based on earlier and widely circulated data protection guidance from Hse regional consumer affairs managers.

WhaT To Do WheN a breaCh Does oCCur all information / data breaches must be reported to the Consumer affairs or ICt Manager immediately. Members of staff and their line manager must complete a Data Breach Incident report and forward (via fax or email a scanned copy) to their local Consumer affairs area Office for any breaches involving manual (paper based) information / data or to their local ICt call centre / helpdesk for any breaches involving electronic data. the local Consumer affairs area Office will notify the Data Protection Commissioners office of the breach if required. any queries you have on Data Protection can be addressed to your local Consumer affairs offices, details are available on www.hse.ie.

GROVE MOTORS Aisho Construction Ltd

T: 074 91 37899

Trentagh, Letterkenny,

E: info@boyleconstruction.ie

t/a Boyle Construction Co.Donegal

F: 074 91 37820

www.boyleconstruction.ie

Boyle Construction was formed in 1984 by Donal and Eugene Boyle. The company has grown over the years and is now ďŹ rmly established as one of the leading Building Contractors in the Northwest. We are ISO 9001 Quality Assured and Safe T Cert Accredited.

We are happy to be associated with the HSE as the Main Contractor for the New Primary Care Centre in Glenties, Co. Donegal.

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Service and Parts for DAF trucks and LDV vans Authorised workshop for Tachographs and Road Speed Limiters Breakdown Rescue and Recovery also available Our 6,000 sq ft workshop is equipped with all necessary diagnostic equipment to service and repair all commercial and emergency vehicles. Grove Motors Ltd. Main Street Newtownmountkennedy Co. Wicklow Tel: 01 281 9803 Fax: 01 281 9855 Email: info@grove-motors.com

08/12/2011 16:38:22

Medray supply high quality uniforms to Irish healthcare professionals.

Uniforms from:

€20 Visit and buy your uniforms from our newly launched online shop at:

www.medray.ie

Special discount for departmental orders of 30 plus garments. *Terms & Conditions apply, offer expires 31/12/2011

T: +353 1 466 3773 E: info@medray.ie W: www.medray.ie

car & home insurance now even easier with AXA EasiPay EasiPay allows many health care employees to pay their motor and home insurance premium directly from their salary over 10 months at no extra cost. You can also get up to 10% discount on your motor insurance (new or renewal) and free 24 hour breakdown assistance.

What’s more, employees on the Easipay scheme can get 10% off a new home insurance policy or €30 off your home renewal. AXA customers can also save money on new and used cars, holidays and lots more. Just visit www.axaplus.ie.

For more information and to find out if your employer is part of the EasiPay scheme drop into your local AXA Insurance branch or call us on 1890 600 600

Terms and conditions apply. Free Motor Rescue Plus breakdown cover is available to existing customers at next renewal. AXA Insurance Limited is regulated by the Central Bank of Ireland. (248X AD)

HM Iss7.4 p1-32.indd 32

redefining

standards

redefining

standards

08/12/2011 16:38:26

Health Matters 33

information

Library services at your fingertips Library services are now easily accessible to all HSE personnel through the HSE library website www.hselibrary.ie.

ibrary services are available to all HSE personnel and are easily accessible. The HSE library website, www.hselibrary.ie, is developed and maintained by a team of librarians across the HSE. A wide variety of material and resources are available including e-journals, e-books, databases, clinical practice guidelines, patient handouts and much more. Subject areas include medicine and surgery. nursing and midwifery, mental health, allied health and social care, health service administration and management.

Registering an Account The electronic resources on www.hselibrary.ie can be accessed via any computer with an Internet connection. To access these resources, you need to register for an Athens account. This is a self-registration process, which can be completed by clicking ‘Set up My Athens Account’ on the homepage of your area library service. To complete the registration process, you will need your HSE personnel number and an email address. Your Athens account details will be forwarded to the email address you provide. Ask a Librarian and Clinical Queries HSE librarians are expertly trained in locating quality health information. We can carry out an information search for you or recommend the quickest route for you to find the information yourself. Click ‘Ask a Librarian’ or, in some areas, click the ‘Clinical Queries’ tab to submit a question to your local HSE library. Training HSE librarians provide training for all the electronic resources available on the website. To book a training session, please contact your nearest HSE library. There are

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also tutorials, user guides and help sheets available to download from the website.

nearest HSE library and we’ll try to source a reprint of the article for you.

Borrowing Books To borrow books, you must complete a library registration form. Call into your local HSE library or download the registration form from the website. Each region has its own library catalogue. Search the catalogue for the subject you’re interested in, then contact your local HSE library to request a copy of the item you need.

IT facilities Internet access, printers, photocopiers, scanners, etc. are available for use in most HSE libraries.

Keep Up to Date Keeping up to date with new developments in health sciences literature can be daunting and time-consuming; however, it doesn’t need to be. Contact your local HSE library to find a range of current awareness services available to help you keep on top of the latest literature in your discipline.

“To borrow books, you must complete a library registration form. Call into your local HSE library or download the registration form from the website.”

Document Supply Service If you’re looking for a book, article or report that isn’t available locally, contact your

08/12/2011 16:43:16

34 Health Matters

feature

Winter Gardening by Plantmarket As winter weather is upon us, its now time to reflect on the last season’s success and failures in the garden. This is where the fun starts and can be exciting. The new season catalogues are out now, packed full of colour, tips and tricks and new season offerings, so the cold winter is the ideal time to plan your garden for next summer.

Shrub borders General shrub borders should be tidied, removing all leaves and pruning back over grown plants to a more manageable size. Plants such as rhodendrons and azaleas should be top dressed with compost ready to protect their roots and leave ready for spring.

“Winter interest is entirely subjective, and only you can decide what is attractive to your eye, or what looks tired and messy.”

©istockphoto.com/sunara

ook at your garden and its various elements, shrubbery, lawn, perennials, bedding border and vegetable garden. Make your notes on each section and decide what you would like to do for the new gardening period of next spring and summer. When the weather allows, to keep active you can tackle the following; You can continue to occasionally top your lawn throughout winter if it remains mild, only if there is no frost. Apply sharp sand to the surface and spike all those compacted areas where there has been a lot of traffic such as the clothes line or short-cuts across the lawn. Collect all leaves and add them to the compost heap. Don’t leave them on the lawn as this will damage the grass beneath and make more work in spring.

A couple of good, hard frosts makes a big difference in the garden. Some perennials immediately begin to go dormant, while others seem to want to hang on into late autumn. To those new gardeners out there, we encourage you to consider leaving most perennials alone in the autumn if you are unsure of what winter interest they might provide. It would seem a shame, for instance, to cut back those big, beautiful clumps of ornamental grasses in the fall, ruining any opportunity to hear them rustling in the winter winds, or to enjoy the contrast of their wheat-coloured stems against clean, crisp frost. Winter interest is entirely subjective, and only you can decide what is attractive to your eye, or what looks tired and messy.

Seed-heads Seed-heads of certain perennials provide food for finches and other birds, and they

HM Iss7.4 p33-64.indd 34

look great against a blanket of snow. Most late-flowering daisy-type perennials are on this list (like Rudbeckia and Purple Coneflower), but others with nice seedheads and sturdy stems include: Achillea, Aster, Eryngium, Eupatorium, taller Sedum. Many perennials have very little winter interest. Cutting these types back in the late autumn effectively “clears the clutter” and makes the ones you leave look even better. Consider cutting these down in late Autumn or early winter: Alchemilla, Anemone, Campanula, Centaurea, Coreopsis, Dicentra, Geranium, Lychnis, Monarda, Nepeta, Oenothera, Phlox (tall types), Trollius, Veronica. Certain perennials naturally carry over a low clump of evergreen leaves near the ground, known as a “rosette”. Although you can trim the upright stems back, these lower leaves need to be left alone

08/12/2011 16:43:18

Health Matters 35

feature ©istockphoto.com/benedek/dtimiraos/Eerik/BasieB/Floortje

Viburnum tinus Eve price; Chimonanthus praecox; Skimmia rubella) • Climber (Jasminum nudiflorum). •F lowers (Helleborus; Cylamen Winter pansies)

in the autumn/winter. By spring they often look a little worse for wear, but a quick trim with scissors (only the brown or dead parts) will tidy the plants up again. In this group are: Aster, Coreopsis, Digitalis, Erigeron, Gaillardia, Geum, Heuchera, Bearded Iris, Shasta Daisies, poppies, Polemonium, Salvia, Scabiosa, Stachys,Verbascum, and many of the hardy ferns.

Evergreen evergreen perennials Evergreen perennials and alpines should not be trimmed in the autumn. Usually the best time to trim these is immediately after blooming, if at all. Leave these ones alone in the fall: Ajuga, Alyssum, Arabis, Armeria, Aubrieta, Aurinia, Bergenia, Cerastium, Corydalis, Dianthus, Epimedium (trim in late winter, before new buds appear), Helianthemum, Helleborus, Heuchera, Iberis, Kniphofia, Lavender, Origanum, Phlox (creeping types), Saxifraga, Sedum (many creeping types), Sempervivum, Teucrium, Thymus, Viola. Winter Wonders There are lots of plants that flower or look their best in winter: • Trees (Betula Jacquemontii; Prunus autumnalis rosea; Acer sangokaku). • Shrubs (Mahonia Japonica Sunburst;

HM Iss7.4 p33-64.indd 35

Mulching The idea of a mulch is to add a layer of insulation on top of the soil, preventing sudden changes in soil temperature (from either deep freezing or thawing), changes that can wreak havoc to the root systems of tender plants. A late autumn mulch can really help in certain cases. Last year’s compost, manure or wood chips can be very good and easily applied, not to mention making room for this year’s garden debris. Mulching materials should be organic matter that remains loose and won’t pack down to suffocate your plants. Good choices might be dried leaves (a mix of different types is best), clean straw, chopped dead tops from other perennials, evergreen cuttings from pruning. Bad choices: peat moss, garden soil, newspaper, sheets of plastic or garbage bags. All of these have a smothering capability. Remember good air circulation is the key to success. Mulch can be simply piled high on top of your plants, but a depth of six to eight inches or more is ideal. Mulch bare vegetable areas to prevent winter rain from washing nutrients out of the soil. Cover mint and parsley to keep it frost free and producing fresh greens for the kitchen. Dig out any remaining beetroots, potatoes or carrots before the frost gets them. Make sure that your bird feeders are well stocked and while you’re at it install a bug hotel for all those very helpful insects that labour all year to keep your garden healthy. Remember with Christmas coming you could put this on your wish list. Plantmarket Plantmarket is one of 22 services provided by the HSE’s Eve network, which offers a range of community-based training and work services for people with mental health difficulties in Dublin, Wicklow and Kildare. Plantmarket Garden and Training Centre is located at Blake’s Cross near Lusk in north Dublin and is open to the public on weekdays from 9am to 4.30pm (Monday to Thursday) and from 9am to 3.30pm (Friday).

08/12/2011 17:27:05

36 Health Matters

children first

the Child Protection and Welfare Practice Handbook The launch of a new handbook to complement guidelines set out earlier this year, will assist front-line staff in protecting vulnerable children. of information between agencies and disciplines in the best interests of children and the need for full cooperation to ensure better outcomes. Launching the handbook, Minister Fitzgerald said: “I welcome the publication of the Child Protection and Welfare Practice Handbook by the HSE. This handbook will be a valuable resource in ensuring a nationwide consistency of approach to the implementation of the Children First guidance 2011, and to the enhanced delivery of children protection services generally.

Back (L-R): David Walsh, Area Manager, Dublin South West/Kildare; Marie Faughney, Child Care Manager; Ger Brophy, Acting Principal Social Worker; Collette McLoughlin, Social Care Manager, Dublin South West; Cormac Quinlan, Principal Social Worker, Dublin South West. Front (L-R): Gerry O’Dwyer, Regional Development Officer, HSE Dublin Mid Leinster; Minister for Children, Frances Fitzgerald, TD; and Gordon Jeyes, National Director, Children and Family Services, HSE.

inister for Children, Frances Fitzgerald, TD, launched the HSE’s Child Protection and Welfare Practice Handbook at four regional launches during September. The handbook was developed by the HSE’s National Office for Children and Family Services and is based on protocols set out in Children First: National Guidance for the Protection and Welfare of Children (2011) and the collective wisdom and best practice of experts and front-line staff. It will support the vital work of Social Workers and other relevant practitioners in dealing with child protection and welfare cases. The introduction and use of the Child Protection and Welfare Practice Handbook will standardise the nationwide implementation of Children First, which

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promotes the protection of children from abuse and neglect. The guidance states what organisations need to do to keep children safe, and what different bodies and the general public should do if they are concerned about a child’s safety and welfare. It sets out specific protocols for HSE Social Workers, Gardaí and other front-line staff in dealing with suspected abuse and neglect.

A Multidisciplinary Approach The scope of the guidance extends beyond reporting to statutory bodies. It emphasises the importance of multidisciplinary, interagency procedures in the management of concerns about children’s safety and welfare. Key to this is the sharing

“It takes a whole community to keep a child safe and we all have a responsibility for ensuring the safety of children in Ireland. I welcome this handbook as an important development in child protection and welfare in Ireland.”

“My department is finalising legislation to put the Children First guidance on a statutory footing for the first time. This legislation will apply to all organisations and persons who work with or are in contact with children and will include statutory requirements to make

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children first reports, share information and cooperate with the HSE and An Garda Síochána where they are involved with a child about whom there are concerns. “It takes a whole community to keep a child safe and we all have a responsibility for ensuring the safety of children in Ireland. I welcome this handbook as an important development in child protection and welfare in Ireland,” she concluded.

A Valuable Resource Gordon Jeyes, National Director, Children and Family Services, HSE, said: “Our top priority as children and families professionals is to implement Children First guidance 2011. The vital work of Social Workers and other professionals together with partner agencies in assessing risk and acting to protect vulnerable children is difficult and demanding. This practice handbook is designed as a quick reference book to help support front-line practice. It sets out the key issues in the different stages of action from referral through assessment to intervention.” The handbook is designed to complement Children First, which is the full reference text for practitioners. It is a companion to this guidance, as well as current policies and procedures and Irish legislation. “The handbook is a guide to basic and consistent practice but it cannot and does not cover everything,” adds Jeyes. “The task for all of us is to use our professional skills, work together and offer an accountable, consistent and transparent child-centred service to protect children. The handbook builds on the skill, resilience and determination of agencies working together to put children first. It is a professional guide to help us be reliable and dependable partners and to ask the same of others.” Detective Chief Superintendent Padraig Kennedy of the National Bureau of Criminal Investigation said: “On a daily basis, An Garda Síochána is working with other agencies to protect children from harm and abuse. Children First is an integral element of the policy of An Garda Síochána on the investigation of sexual crime, crimes against children and child welfare. The publication of the Child Protection and Welfare Practice Handbook further enhances the ability of An Garda Síochána to deal with child protection concerns and supports the

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(L-R): Gordon Jeyes, National Director, Children and Family Services, Linda Creamer, Principal Social Worker; Minister for Children, Frances Fitzgerald TD; Phil Garland, Assistant National Director, Children and Family Services; and Claire O’Kelly, Regional Specialist Children and Family Services.

difficult and challenging work of those on the front line of child protection and welfare.”

“The handbook builds on the skill, resilience and determination of agencies working together to put children first. It is a professional guide to help us be reliable and dependable partners and to ask the same of others.” National Roll-Out Since the launch of Children First in July and the launch of the Child Protection and Welfare Practice Handbook, hard copies of the books have been issued to all Health Areas with prioritisation to Social Workers, Public Health Nurses and Designated Officers. In addition, all health areas are

providing briefings for all children and family services and allied professionals to ensure that all key staff are fully aware of their roles and responsibilities. All four regions are required complete these by December 2011. Training has been strengthened and all newly recruited HSE Social Work and allied professionals have access to Children First training coordinated from the regional Children and Family Services Trainers. In addition, the joint training between HSE and An Garda Síochána has been developed and is being provided. The HSE funds many voluntary and community sector agencies and a key priority is to ensure the standardisation of child protection and safeguarding practice across all organisations. The Children First Information and Advice Officers are currently providing cascading briefings and ongoing training to these agencies. Copies of the Children First guidance 2011 and the Child Protection and Welfare Practice Handbook are available from the Government Publications Office, Molesworth Street, Dublin 2, or can be downloaded from www.hse.ie/go/ childrenfirst. The HSE urges anyone who has suspicions or concerns about a child’s safety to contact the GardaÍ or their local HSE Social Work office.

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foster Care Would you consider becoming a Foster Carer? For anyone who thinks he/she may wish to foster, the first step is to contact your local HSE office and speak to a member of the Foster Care Team, writes Mary Cummins.

f you wish to become a foster parent, get in touch with the Foster Care Team at your local HSE office. At this initial enquiry, the Social Worker will explore your circumstances and inform you on what is required. You may also be invited to an information meeting in your area. A Social Worker will then arrange to visit your family to explore whether there are any particular reasons why you should not consider proceeding at this time. If you decide to proceed, you will complete an application form to the HSE. You will be asked to provide references, complete a medical report, and sign consent for Garda vetting and HSE checks for current and previous addresses.

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“The needs of children are all different, as are the different types of care.”

Support to Foster Carers The HSE currently pays a maintenance allowance of s325 to s352 per week for each child in Foster Care. This allowance does not affect tax or state benefits. Each child has a medical card, and Child Benefit may also be paid. The foster family have their own Social Worker, whose job it is to support and assist the foster family

in caring for the child, and each child in care has a Social Worker who visits the child in the foster home and maintains links with the child’s own family. Other supports available may be Public Health Nursing, Speech and Language Therapy, Psychology, an assigned Child Care Worker, or counselling, as appropriate to the child’s needs. Ongoing support and training groups are also provided, while additional support can be obtained from the Irish Foster Care Association, who provide peer support, ongoing training and opportunities to link with other Foster Carers. Currently, HSE South is urgently seeking Foster Carers, particularly for teenagers in Cork city and county If you have ever considered whether you would like to become a Foster Carer, why not call your local HSE office today to find out more? Or pass on this information to anyone you know who may be interested. Mary Cummins is a Family Placement Initiative Coordinator based in Dublin.

©istockphoto.com/cpaquin

Making the Right Match To complete your assessment, a Social Worker will meet with you a number of times, as a couple and individually, to explore with you the life experiences you have had, as these could give you special understanding of the needs of the children who require care. If you have children, their needs will also be considered. In addition, you will receive training, along with others, on the skills and knowledge required in fostering. Your Social Worker will prepare a report based on the discussions with you, your family, your referees and others, and from this will recommend the type of Foster Care and age of children suited to your circumstances. This report will be shared with you and your views represented. The Foster Care Committee will make a decision and, if you are approved, your name is added to the register of approved Foster Carers. The needs of children are all different, as are the different types of care. Some Foster Carers offer Short-Term Care only. Long-term Care is needed for children who are unlikely to be able to live with their birth family. In this situation, many children live with the foster family until adulthood. Other types of care that Foster Carers provide is Emergency Care, which may just last for a

few days; Respite Care, which may be for weekends or short holiday periods; and Day Foster Care, which provides a support system in the community with the child returning to his or her family every evening.

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crisis pregnancy

Education on relationships and sexuality The HSE Crisis Pregnancy Programme has recently published b4udecide.ie relationships and sexuality education resource materials for use in schools and youth work settings.

4udecide.ie is a web-based education initiative that aims to encourage young people to make healthy, responsible decisions about relationships and sexual health, with the ultimate aim of delaying early sex. Frances Fitzgerald TD, Minister for Children and Youth Affairs, launched the b4udecide.ie resource materials. Lesson plans are currently being disseminated to post-primary schools and youth work settings nationwide. The lesson plans support this web-based initiative and are targeted at teachers and youth workers. They were developed by the Programme with the Department of Education and Skills and the National Youth Council of Ireland.

Under pressure The initiative was developed in response to extensive research, which found that young people are having sex at an earlier age than in previous generations and young people who experience first sexual intercourse before 17 years of age are 70 per cent more likely to experience crisis pregnancy in their lifetime, three times more likely to report having a sexually transmitted infection (STI) and three times more likely to experience abortion. Those who had sex before 17 were also more likely to wish they had waited longer before having sex. Dr Stephanie O’Keeffe, Acting Director of the Crisis Pregnancy Programme, said: “While we have seen sustained reductions in teenage pregnancy and teenage abortion rates over the last ten years, evidence shows that young people continue to face immense pressures from the internet, advertising and of course, their peers. Providing sex education, in school and in the home, is the single most important thing we can do to prevent unplanned pregnancies and the spread of sexually transmitted infections.”

for parents, teachers and youth workers, to help them talk to teenagers about relationships and sex. B4udecide.ie includes videos of young people talking about their experiences, a counsellor talking about healthy relationships, real stories from teenage parents and quizzes and polls. B4udecide.ie also has a section for parents, teachers and youth workers that provides information on talking to teenagers about relationships and sex, outlines the relationship and sex education curriculum that is taught in schools and outlines resources and training that can assist in the provision of relationships and sex education in the home, school or youth work setting. To order b4udecide.ie Relationships and Sexuality Education Resource Materials for Teachers or Youth Workers, visit www.healthpromotion.ie. For more information: visit www.b4udecide.ie.

Sex education The campaign is for teenagers and also

Free Relationships and Sex Education Resources for

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Dr Stephanie O’Keeffe, A/Director, HSE Crisis Pregnancy Programme and Minister for Children and Youth Affairs, Frances Fitzgerald TD

Health Care Professionals There are a number of free relationships and sex education resources available from the Crisis Pregnancy Programme: Busy Bodies – DVD and Booklet for Parents of 10-14 year olds. To order a copy of the booklet and DVD, FreeText BUSY plus your name and address to 50444. You Can Talk To Me – DVD and booklet for parents of 11-15 year olds. To order a DVD and booklet, FreeText PARENT plus your name and address to 50444. Parents Tips for Talking to Older Teenagers – Supplement for parents of 15-17 year olds. To order a copy of the supplement, FreeText TALK plus your name and address to 50444. The Facts – DVD and booklet to help parents, teachers and youth workers provide sex education to young people. FreeText FACTS plus your name and address to 50444. Resources can also be ordered directly from www.healthpromotion.ie.

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your stories

Night Owls In his latest update on life as a hospital intern, Kapil Sharma feels isolated during his first week on night call, but his presence is justified when someone becomes unwell.

“P

ut your hand on a hot stove for a minute and it seems like an hour. Sit with a pretty girl for an hour and it seems like a minute. That’s relativity.” I hope you will forgive the pretentiousness of beginning with a quote from Einstein, but I have recently finished my first week of night call and have really become cognisant of the relative nature of time. Two main scenarios can play out when one is on call overnight. A quiet night involves doing regular ward jobs (intravenous lines, prescriptions, charting fluids and taking bloods) or dealing with any outstanding issues that the Day Team were too busy to do. By about midnight or soon thereafter your bleep can fall silent; occasionally it may alert you to another routine task through the night, but patients are asleep and all is well. In this case, time moves slowly; the night hours stretch out and I’m content, maybe a little bored from inactivity. Comparatively, a busy night can be quite nerve-racking. A patient deteriorates overnight; in the worst case, unexpectedly – that is to say, the last note in the chart will be something along the lines of ‘Patient doing well, for discharge mane’. I frantically look back through the notes to identify possible reasons, perform a series of tests and succinctly present the findings to the Registrar on call who sees through everything and advises the appropriate treatment. The patient improves. These hours pass like minutes as I am sharply focused on the task at hand. The great thing is that time is unforgivingly constant and when dawn approaches it is reassuring to know that the full day shift is about to take over.

Living Forward Time and what to do with mine is a subject that I have had to think about a lot lately, I first started to write these articles a little under a year ago; I was still a naive student, anxious about passing my exams. Thankfully, that time has well and

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truly ended, and as I reach the mid-point of my intern year the focus has shifted to the future.

“The question is: what do I want to spend the rest of my working life doing?”

As the New Year approaches, applications for general practice, medical, surgical and specialty jobs will commence. Applications are competitive and involve ranking candidates based on their CV and interview performance. These interviews occur early in 2012 and, having never interviewed for a job before, I await them with significant trepidation. The question is: what do I want to spend

the rest of my working life doing? Interns are fortunate in that the choices are vast, and one can always change from one path to another, but making the decision is quite daunting to me. Kierkegaard pointed out that life has to be lived forward, but can only be understood backwards. My biggest concern is that I’ll pick a field now and regret not doing something else years later, but as long as I don’t end up in a career I despise I think things will be fine. One benefit of writing these pieces is that it gave me the time to be reflective and ponder my life thus far as an intern. Very few jobs can give you the breadth of experiences that this one does, and very few allow you to engage with people in such a meaningful and consistent way, not just with your patients, but with colleagues also. Although frustrating and difficult at times, being a doctor is the most fulfilling job that I can imagine and, as for what the future holds for me, all I can say for now is watch this space!

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your StoriES

WorLd-CLass training deLivered by dr riCHard steevensâ&#x20AC;&#x2122; sCHoLarsHip programme dr frank Waldron-Lynch, mb, phd and specialist trainee in endocrinology, who has been awarded the Hse dr richard steevensâ&#x20AC;&#x2122; scholarship in order to complete a clinical fellowship in immunology of type 1 diabetes at yale school of medicine, writes about his experiences.

n 2009, I successfully applied for a Dr richard steevensâ&#x20AC;&#x2122; scholarship funded by the Health service executive, which enabled me to continue my specialist registrar training in endocrinology subspecialising in the treatment of newly diagnosed type 1 diabetes patients with immunotherapy at the section of Human translational Immunology at Yale University. type 1 diabetes is the commonest severe chronic autoimmune disease characterised by immune-mediated destruction of pancreatic beta cells leading to insulin deficiency and hyperglycemia at its onset. In Ireland, some 14,240 people are estimated have type 1 diabetes. Internationally, Ireland has the fourth-highest incidence of type 1 diabetes with 17 cases per 100,000 population per year, with only scandinavian countries exceeding this rate. Moreover, the incidence of type 1 diabetes is rapidly rising in children, with a predicted doubling of cases in children aged under five years over the next 15 years in europe. Current therapy in type 1 diabetes involves replacement of insulin and has been incrementally optimized over the last 90 years with the development of insulin analogues, self-monitoring of glucose, insulin pumps, structured education programmes and cardiovascular risk modification to improve outcomes. Despite these interventions, patients with type 1 diabetes continue to live with a life-long chronic disease that requires attention to the most basic aspects of survival at all times and may reduce their life expectancy. this has led to significant efforts to develop immunotherapy with novel biological agents to prevent or reverse type 1 diabetes. Immunotherapy aims to restore rather than

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62 Health Matters

your stories “The experience gained at Yale will enable me, on return to Ireland, to commence an immunotherapy programme to treat patients with type 1 diabetes.” to arrest the autoimmune destruction of pancreatic beta cells and preserve insulin production in patients with type 1 diabetes. The Section of Human Translational Immunology (HTI) at Yale School of Medicine is one of the few centres worldwide that can offer experience in treatment of new onset type 1 diabetes with immunotherapy. The HTI section is a new programme whose mission is to accelerate the application of new developments in the field of immunology to the treatment of human diseases. It is part of the Department of Immunobiology with 21 people in the faculty, four of whom are investigators funded by the Howard Hughes Medical Institute (HHMI). Close links exist with the Department of Endocrinology, which comprises 33 people in the faculty, of which one is HHMI-funded, and six clinical and 20 research postdoctoral fellows. Faculty staff in both departments, are part of the Yale Medical Group consisting of 800 physicians largely based at Yale-New Haven Hospital, a 944-bed tertiary referral centre.

Trials and Investigation My fellowship was directly supervised by Dr Kevan Herold, who is Professor of Immunobiology and Medicine at Yale. The focus of his investigative work is on developing new ways to prevent and treat type 1 diabetes. He has studied and is developing novel immunologic and metabolic approaches that have been able to prevent the progression of type 1 diabetes, and is involved in a number of national and international clinical studies of new treatments. He and his colleagues initially reported on the use of an anti-CD3

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monoclonal antibody to treat patients with new onset type 1 diabetes, which is now in clinical development. His laboratory studies, which involve both patient samples and models of type 1 diabetes, focus on the mechanisms of immune regulation, with the goal of improving on this initial success with anti-CD3 antibody and achieving a stable reversal of diabetes. The aim of the fellowship was to train in the design, initiation and conduct of clinical trials of immunotherapy of patients with type 1 diabetes. I was registered at Yale as a co-investigator on five randomised placebocontrolled clinical trials of immunotherapies to either prevent or reverse the loss of endogenous insulin production in patients with type 1 diabetes. Two of these trials – the Autoimmunity-Blocking Antibody Therapy for Tolerance in Type 1 Diabetes (AbATE) and Anti-CD3 mAb Treatment of Recent Onset Type 1 Diabetes (Delay) trials – have been recently completed and reported. Both trials showed that Teplizumab, a humanised monoclonal anti-CD3 non-binding FcR antibody, was effective in preserving endogenous insulin production in patients with new onset or recent onset diabetes (zero to eight months post-diagnosis). Teplizumabtreated patients were also found to require less insulin to control their blood sugars though none had full reversal of their diabetes. The experience gained at Yale will enable me, on return to Ireland, to commence an immunotherapy programme to treat patients with type 1 diabetes. This programme would allow Irish patients to participate in and receive the latest advances in the treatment of type 1 diabetes to improve their clinical outcomes. The programme would allow for the latest research discoveries to be rapidly translated into benefits for patients. I am grateful to the HSE for awarding me the Dr Richard Steevens’ Scholarship and to the Royal College of Physicians of Ireland for enabling me to complete my training as a Physician-Scientist. For further information on type 1 diabetes research, see: ‘Immunomodulatory therapy to preserve pancreatic beta-cell function in type 1 diabetes’, Waldron-Lynch and Herold, Nature Reviews Drug Discovery, June 2011 http://bit.ly/sDptVx. TrialNet www.diabetestrialnet.org and the Immune Tolerance Network www.diabetestrialnet.org which coordinate clinical trials in type 1

diabetes. Yale School of Medicine http://medicine.yale.edu. You can find Dr Waldron-Lynch on www.linkedin.com.

Glossary • Type 1 diabetes is caused by the autoimmune-mediated destruction of pancreatic islet beta cells, which usually leads to absolute insulin deficiency. • Pancreatic islet beta cells are specialised endocrine cells located in the islets of the pancreas that secrete insulin in response to increases in blood sugar. • The immune system is composed of special cells, proteins, tissues, and organs that protect the body against attacks by ‘foreign’ invaders such as bacteria or viruses. • Tolerance is the failure of the immune system to respond to an antigen. The immune system is usually tolerant to self-antigens. • Autoimmune the mechanism by which the immune system loses tolerance to self-antigens leading the destruction of pancreatic beta cells in type 1 diabetes. • Immunotherapy is treatment that aims to suppress or enhance immune responses. • Biological agents are drugs that are produced by biologic processes, rather than being chemically synthesized. • Translational medicine is the integration of research from basic sciences to improve patient care.

The Dr Richard Steevens’ Scholarship The Dr Richard Steevens’ Scholarship is managed by the HSE’s Medical Education & Training Unit and is awarded annually to sponsor doctors to train in novel areas of medicine that are limited or unavailable in Ireland, and to bring the skills learned back to the Irish health service. The scholarship is in its sixth round and the application process for 2012 recently closed. Awards for scholarships commencing in July 2012 will be announced early next year. For further information email met@hse.ie.

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your StoriES

simpLe ideas are best… innovation aLive and WeLL in naas transition year students in kildare have come up with an innovative health kit for teenagers, which aims to help youngsters make healthier choices.

ini Company Directors of Fresh, Fit and Feisty, Katie O’Houlihan, Paola Clarke, leah Headon, Claire Grogan, and eadaoin Burke – all pupils in st Mary’s College in Naas, Co. Kildare – are hoping to bring their unique product to market by the end of the school year. leah Headon, Marketing Director, explains how the business idea originated: “Our idea evolved on the basis that obesity is on the rise in Ireland and we, as a group of healthconscious teenage girls, want to combat this problem in a safe and healthy way.”

cReating the kit the idea is simple: to manufacture a health kit that will appeal to teenage

girls and boys. the kit devised by the transition year students contains a portion control wheel, which is divided into three sections – protein, veg and carbohydrates – to indicate the correct portion sizes that should be served at each meal. a nutritional information booklet provides healthy exercise plans and some quick and easy recipes, and literature from Hse-led public health campaigns such as the recent QUIt anti-smoking campaign are also included to educate and inform the target audience. the kit also contains handy accessories for healthy teens: an eco-friendly reusable water bottle that is dishwasher-safe, and freezer-safe and – best of all – can be folded up for convenience when not in use; and a stylish rubber sports watch infused with negative ions, which can help to increase balance and energy levels. all of this comes wrapped in a waterproof sports bag.

+ Mini Company Directors of Fresh, Fit and Feisty (top to bottom): Paola Clarke, Finance Director; Claire Grogan, sales Director; Katie O’Houlihan, CeO; leah Headon, Marketing Director; and eadaoin Burke, Production Director.

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gReat potentiaL the aim of this product is to promote healthy living and to create awareness about the growing level of obesity in Ireland. Not only does the kit provide teenagers with important information on portion control and nutrition and teach them how to eat healthily and responsibly, it encourages them to live active and healthy lives. Potentially, Fresh, Fit and Feisty’s health kit has benefits for dietitians, doctors and parents, all of

“the idea is simple: to manufacture a health kit that will appeal to teenage girls and boys.” whom have already expressed an interest in the concept. the company is now going through the patenting process, and the students have sourced their suppliers, and set up a website www.freshfitandfeisty. com which has already attracted potential customers who have registered to find out more. these budding entrepreneurs are eager to develop their innovative product and have further plans to build on their brand by expanding their target market to include younger children, adults and the elderly.

body confident as teenage girls, the team behind Fresh, Fit and Feisty are very aware of the constant bombardment of ideal body images from magazines, television and the fashion world. they want to offer a healthy solution to help decrease body consciousness and increase teenage body confidence. Katie O’Houlihan, CeO, explains: “We thought of issues that everyone deals with on a day-to-day basis and came up with easy solutions that everyone can have a go at. It’s just about becoming confident in your body in a natural, healthy way.” Fresh, Fit and Feisty, the company set up by five innovative teenage students, is certainly one to watch out for in the future.

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feature

Pressure Cooker Filling out an application form on a whim landed Brídín Carey onto an Irish TV programme watched by hundreds of thousands of viewers.

ven after she applied, Brídín Carey, Occupational Therapist at the National Rehabilitation Hospital, Dún Laoghaire, never expected that she would end up being a contestant on RTÉ’s popular programme, MasterChef Ireland, let alone that she would make it to the final. The Tipperary native, who appeared on the show broadcast on RTÉ Two in October, had just returned from travelling around Africa and Australia when her friends encouraged her to apply. “I received emails [while travelling] from friends encouraging me to fill in the application form,” she recalls. “Like most things, I didn’t put much thought into it and just completed the form on a whim, but it all worked out well in the end!”

From OT to TV Describing her time on the show as “a fantastic experience”, Brídín observed that her background in healthcare helped her to deal with the pressure of the MasterChef kitchen. “There were highs and lows but I think, having worked as a health professional for so many years, I was well equipped to deal with the stress of the challenges that were put forward.” Brídín, who has worked at NRH since 2006, finds her cooking skills invaluable as a therapeutic tool. “We’ve recently launched an amazing therapy garden in the OT department which includes vegetable patches, fruit trees and a polytunnel for growing fruit and

+ Brídín Carey and Christine O'Sullivan at Taste of Christmas

vegetables. All the seasonal produce will be grown by our patients and then used in the OT kitchen to rustle up some tasty dishes,” she explains.

The Reality of Television

A typical day of filming involved arriving at the studio near Kilmainham at around 7am. “We never knew in advance what challenge was coming up, so it was always a surprise and often involved being whisked away to some secret

Flora pro.activ recently conducted a nationwide, free of charge cholesterol screening campaign called the Flora pro.activ Cholesterol Challenge and found that 58% of Irish adults have higher than the recommended level of cholesterol, which can increase the likelihood of developing heart disease.[1] Flora pro.activ foods contain plant sterols, which are clinically proven to significantly lower bad (LDL) cholesterol by 10% and a further 5% when combined with a healthy diet and lifestyle. Over 45 clinical studies have proven that Flora pro.activ foods significantly lowers cholesterol and the foods are endorsed by the World Heart Federation.

www.florahearts.ie

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[1] As heart disease has multiple risk factors, consumers may need to improve more than one to reduce their overall risk

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feature location for filming,” says Brídín. “as you can imagine, the conspiracy theories were rife as paranoia set in about what the production team would make us do next.” the day was often divided between elaborate demonstrations, extensive interviews, a bit of cooking and lots of waiting around for results. “every entrance we did either down the stairs or into restaurants was done at least five times,” Brídín reveals. “You were interviewed before, during and after each challenge, so eventually they got some interesting one-liners. It was fascinating watching back over the show, how they edit down three days of footage and compact it into a single hour for tV.”

Tremendous supporT luckily, Brídín’s Manager, lisa Held, and the Hr staff in the NrH were very supportive of her request for unpaid leave for seven weeks. “all in all, everyone was a tremendous support throughout the filming and airing process. I’ve even received cards and emails from old patients and their families with expressions of support,” she says. “there was great excitement in the hospital as most of the patients and staff watched the show. I was told the Health and safety Nurse was driven crazy as patients invariably were sitting on each others beds to watch the show every tuesday and thursday evening!” For the final episode, rtÉ were given permission to film a treatment session in the NrH, which helped to spread the word of the important work done in the hospital. “We also had rtÉ’s John Murray radio show into the hospital in October as I was cooking lunch for all the patients and staff – 250 people – which was a real MasterChef challenge,” adds Brídín. noT QuiTTing The day JoB Brídín finds the NrH a wonderful place to work with new challenges daily, and continuous learning opportunities. looking to her future plans, Brídín says, “Working as an Ot remains my passion but I like to keep busy so I’ve a few projects on the go.” Outside of her Ot hours, Brídín is involved with two other programme contestants in producing tasting menus in venues nationwide.

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FesTiVe Fare BrÍdÍn loVes haVing Friends and Family oVer To her house For Food aT chrisTmas, and she’s happy To share some oF her no-hassle recipes ThaT will saTisFy The hungry moB.

choriZo and goaT’s cheese rolls MAKES 18 ROLLS My husband’s two favourite things to eat are goat’s cheese and chorizo, so you can imagine the excitement when I made these for the first time! I find the soft logs of goat’s cheese with no rind easiest to work with. Once they are rolled and buttered you can wrap them tightly with cling film and they will keep until your guests arrive. INGreDIeNts: • 240g fresh goat’s cheese • 200g dry-cured chorizo, chopped • 2tbsp chives, finely chopped • Freshly ground black pepper • 9 sheets filo pastry • Melted butter, for brushing Preheat your oven to 200°C and line two large baking sheets with parchment, In a bowl, combine the goat’s cheese, chorizo and chives. season to taste with pepper. lay a sheet of filo pastry on a clean, dry work surface and brush it with melted butter. top with two more sheets, lightly buttering each as you go, then cut the layered filo into six long rectangles. Place one tablespoon of the goat’s cheese filling at the base of each rectangle and roll up the filo, folding in the sides as you go. repeat to make 18 rolls. Place the rolls on the prepared baking sheets and brush with butter. Bake for ten minutes, or until golden.

salmon pÂTÉ MAKES 20-30 CANAPÉS this is a seasonal favourite in my house. It is a great way of using up left-over smoked salmon scraps. It only takes minutes to make and will keep in your fridge for a few days. INGreDIeNts: • 200g fresh salmon fillet, poached • 200g smoked salmon • 100g unsalted butter, room temperature • juice and zest of ½ a lemon • freshly ground black pepper • 1 dessertspoon fresh tarragon • 1 dessertspoon fresh dill • 1 preserved lemon (available in most speciality food shops) • 2tbsp water • Crostini or cucumber slices, to serve Place the smoked salmon in a saucepan with 10g of butter and two tablespoons of water. Gently heat until the smoked salmon becomes opaque and allow to cool. Cream the remaining butter in a bowl then add in both the smoked and poached salmon and mix with a fork. Do not blend in a food processor as you want a chunky texture. For a healthier version, substitute butter with crème fraîche or low-fat cream cheese. season to taste with lemon and pepper. serve a spoonful on crunchy crostini or a thick round of cucumber. Garnish with a sprig of tarragon or dill and a sliver of preserved lemon.

08/12/2011 16:56:19

66 Health Matters

copd

Campaign raises awareness of COPD A new nationwide campaign to raise awareness of COPD and promote early diagnosis is being supported by the HSE, the Irish Thoracic Society, the Irish Association of Respiratory Scientists and the Respiratory Nurses Association of Ireland.

t is estimated that 440,000 people in Ireland suffer from Chronic Obstructive Pulmonary Disease (COPD), a general term for a number of chronic lung disorders including bronchitis, emphysema, and chronic airway disease. Research published recently by the Irish Thoracic Society shows that exercise, as part of a programme of care, can ease symptoms such as shortness of breath, wheezing, tiredness, depression and anxiety. One in four individuals are likely to develop and require treatment for COPD during their lifetime. The main cause in susceptible individuals is cigarette smoking, but in a very small percentage of cases the cause may be idiopathic. Once detected, COPD can be managed and treated, slowing down the rate of deterioration of the lungs and greatly increasing quality of life to enable everyday activities. The symptoms are cough, expectoration, and exercise dyspnoea, often accompanied by anxiety, depression and overall reduced quality of life. COPD is characterised by progressive airflow reduction, hyperinflation and inflammatory damage to airways. According to Prof. Tim McDonnell, National Clinical Lead for the COPD Programme: “One of the greatest challenges for people with COPD is not knowing they have it until it’s at an advanced stage. I would urge any smoker or former smoker aged over 40 who has difficulty breathing to get a lung test. When properly diagnosed and treated, patients with COPD can look forward to a marked improvement in their quality of life – with a decline in symptoms such as breathlessness and less frequent flare-ups.”

Raising Awareness Dr Edward McKone, President of the

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+ Pictured on World COPD Day in November are members of the South County Dublin/Dún Laoghaire COPD Support Group during their COPD exercise class in Ballywaltrim Community Centre, Bray, Co. Wicklow.

Irish Thoracic Society, commented that although COPD is one of Ireland’s most common medical conditions, it often goes undiagnosed. Despite the high prevalence of COPD in Ireland there is low awareness of the condition, and campaigns such as World COPD Day are vital in addressing this. Symptoms such as breathlessness, coughing and wheezing can significantly impair a person’s quality of life and ability to do the most basic activities and should not be ignored, added Dr McKone. To mark World COPD Day 2011, on November 16th last, free spirometry (lung testing) and information on COPD, smoking cessation and lung health was provided in some of the main hospitals around the country. Traditionally, pulmonary rehabilitation is set up as a hospital-based programme,

but the recent HSE National Clinical Programme for COPD in the Primary Care Setting has included the implementation of community-based programmes throughout the country, to provide improved access and quality of care for this group of patients, while reducing the costs involved. It is envisaged that programmes will be created in networks nationwide, following on from the implementation of the new Outreach services, and MDTs in these networks will facilitate the running of the programmes. Standardised national referral and assessment sheets, and outcome measure charts, have been designed and are available on the HSE website for use in all programmes, to facilitate the collection of data for research and audit purposes. Information on COPD is available at www.livingwithcopd.ie and www.hse.ie.

08/12/2011 16:56:26

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recycling

Closing the Loop on Recycling Do you ever wonder what happens to recycled material? The majority of Irish recyclables are exported to Europe and the UK, 15 per cent to Asia and China, while a small number of Irish companies are making new products from recycled waste. Most healthcare waste is recyclable, according to Helen Maher, Estates Manager, HSE Environmental Services. ©istockphoto.com/VGchutka

n Ireland, plastic is recycled to produce garden furniture such as picnic tables, fencing and patio decking. Polyester and fleece fabric are also made from recycled plastic. Fleece is used in clothing and carpets, while polyester is mixed with other fabrics to manufacture home furnishings, blankets and bedding. You can recognise recyclable plastic by the symbol of three chasing arrows with a number in the middle. The number indicates what type of plastic it is. Glass can be reused numerous times. Crushed glass mixed with asphalt produces a durable surface used on roads and in other infrastructure projects. Food and green waste are recycled as soil improver and garden bark mulch. Paper is recycled to produce new paper, toilet paper, tissue paper and hand towels.

The Benefits of Recycling Recycling is better for the environment and cheaper than landfill disposal. Rebates are available on baled cardboard and metal as both have market value, while recycling mobile phones, textiles, printer and toner cartridges can raise funds for charity. Using waste to make new products saves natural resources such as oil, metal, and water. Recycling aluminium, for example, saves 95 per cent of the energy used to produce new aluminium. If a product is made from recycled waste, it is stamped with a logo of three chasing arrows with a percentage in the middle. The percentage indicates the proportion of the product made from recycled waste. High Standards The Irish Government recently published a Green Procurement Action Plan, which compels the public sector to apply

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environmental criteria when purchasing goods and services related to construction, energy, catering, transport, cleaning, paper, uniforms, textiles, and IT. Health sector procurement comprises half of public sector procurement – greater than all Government departments and local authorities combined. The European Union Ecolabel is the most difficult environmental standard to secure. While its flower logo may look simple, the environmental criteria behind it are tough and only the very best products, those kindest to the environment, are entitled to carry the label. An Irish company recently launched the first PC worldwide to secure the prestigious EU Ecolabel, and another Irish company achieved the standard for a diary they manufacture which is made from 100 per cent recycled paper and cardboard. Look out for this label on a range of items such as cleaning products, appliances, paper, textiles, and home and garden products.

For more information or advice about recycling in the HSE, please contact helen.maher2@hse.ie.

Quick tips for a Green Christmas

1. Try to minimise excess packaging when buying gifts. 2. Buy recycled Christmas cards and wrapping paper as well as gifts made from recycled materials. And don’t forget to buy rechargeable batteries for all those new toys! 3. Bring your Christmas tree to be shredded and composted. 4. For parties, buy reusable cups, plates, napkins and decorations and recycle all your empty glass and plastic bottles. 5. Compost your organic household waste. For more tips, visit www.recyclemore. ie/repak_green_christmas.

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68 Health Matters

Developments

Capital Developments Health Matters looks at three capital projects underway to improve health services across the country. +

Pictured on the site outside Waterford Regional Hospital where construction is ongoing on a three-storey extension were (L-R): Martin Tritschler, Tritschler, Tritschler and Associates; Brian Cooke, Tritschler, Tritschler and Associates; George O’Neill, Project Manager, HSE South; Lila Kelly, Director of Nursing, WRH; Ed Fennell, Estates Manager, HSE South; John O’Shaughnessy, Deputy Managing Director, Clancy Construction Ltd; Mark Doyle, Consultant in Emergency Medicine, WRH; Patricia Sullivan, General Manager, WRH; Richard Dooley, HSE Area Manager, Waterford/Wexford; and Dr Paul MacMahon, Consultant Paediatrician, WRH.

New Emergency Department at Waterford Regional Hospital

ork is underway on a significant HSE construction project in the South East with the building of a new Emergency Department and Neonatal Intensive and Special Care Baby Unit at Waterford Regional Hospital (WRH). A s9.9 million project, this threestorey construction is underway since November of 2011 and will replace existing facilities. It is earmarked for completion by the end of 2012. The new building in WRH is immediately adjacent to the current Emergency Department (ED), which continues to function during construction. The project is being completed in a number of separate phases, in order to allow existing services to continue in the hospital. A staged handover of the new facilities in WRH will continue throughout the construction process. Patients and the general public are being updated on arrangements during construction.

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Three-storey improvement More than 61,000 patients attend the ED in WRH each year and the new unit will provide a larger, more appropriate environment for both patients and staff. Patient care in the ED is supported by a Minor Injuries Unit, a six-bed Medical Assessment Unit and a 29-bed Acute Medical Unit which facilitates fast-tracking of acutely ill patients and access to senior decision-making about their admission or discharge. The new Emergency Department in Waterford, upon completion, will be of the appropriate size and standard to facilitate the needs of the population of the South East, in terms of rapid access to emergency services in line with the evolving role of WRH as the South East Cancer Centre and Model 4 hospital serving the area. The third floor of the new WRH development will accommodate the relocation of the Regional Neonatal Intensive Care and Special Care Baby Units. The existing unit comprises ten

Intensive Care spaces and a ten-bed Special Care Baby Unit. The new unit will replace both and will meet regional neonatal intensive care requirements, enhancing self-sufficiency where clinically appropriate. This purpose-built facility in WRH will provide comprehensive care for medically unstable or critically ill newborn babies and will be an improved working environment for staff. The second floor of the new capital development in Waterford provides space within the building for additional clinical services, which will be decided as the role of WRH evolves. Patricia Sullivan, General Manager, WRH, says users of Waterford Regional Hospital are pleased to see signs of major construction under way on the campus. It is an indication, she says, of the HSE’s commitment to ensuring more comfortable facilities in one of its major healthcare delivery points. Richard Dooley, HSE Area Manager, Waterford/Wexford, says the WRH project is proceeding on track and that everyone is looking forward to its completion.

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Developments Mater Campus Hospital Development

uilding work is well underway on the Mater Campus Hospital Development (MCHD), a project that involves the rebuilding of key parts of Dublin’s Mater Misericordiae University Hospital. Over one million accident-free man hours have been worked by the main contractor, John Sisk and Son, and it is scheduled for completion in late spring 2012. This development will go a long way to addressing the need for modern buildings and equipment for existing services at the Mater and will provide significant additional capacity to service growing patient needs. New facilities to be provided by the development will include: • New emergency department • New out-patient department • 12 new theatres and ICU/HDU departments • New radiology department • 120 replacement beds, all of which will be single en suite rooms • New CSSD, Catering and Waste Management Departments • New Energy Centre • A new 444-space basement car park on two levels • Expansion space

• Integration with the proposed new Metro station for the campus

Meeting Demand The development will provide for enhanced capacity to meet demand, meaning reduced waiting times for theatre, out-patient and accident and emergency services. The single rooms will help the prevention of spread of infection in accordance with SARI guidelines and will provide privacy for patients as advocated by the Hospice Friendly Hospitals guidelines. Correct departmental adjacencies and signage will assist way-finding through the hospitals and use of natural light, art and green spaces will improve the physical environment and atmosphere. The development will allow for an increase in out-patient and day procedure capacity in the old Mater Hospital, meaning patients can access the service on a day basis. To ensure the smooth transfer of patients, staff and assets to the new hospital, MCHD is working with the hospital on a countdown plan for the hospital stakeholders, including staff, patients, public and visitors, hospital suppliers and contractors, prior to handover.

Pictured at Waterford Regional Hospital, viewing documentation for construction underway on a three-storey extension were: (front row, L-R) Martin Tritschler, Tritschler, Tritschler and Associates; Richard Dooley, HSE Area Manager, Waterford/Wexford; John O’Shaughnessy, Deputy Managing Director, Clancy Construction Ltd; Patricia Sullivan, General Manager, WRH; (back row, L-R) Ed Fennell, Estates Manager, HSE South; George O’Neill, Project Manager, HSE South; Lila Kelly, Director of Nursing, WRH; Dr Paul MacMahon, Consultant Paediatrician, WRH; Brian Cooke, Tritschler, Tritschler and Associates; and Mark Doyle, Consultant in Emergency Medicine, WRH.

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“It is an indication of the HSE’s commitment to ensuring more comfortable facilities in one of its major healthcare delivery points.” – Patricia Sullivan, General Manager, WRH. Glenties Primary Care Centre

his month (December 2011) will see the opening of the new Primary Care Centre in Glenties, Co. Donegal. This new purpose-built building will enable the people of Glenties and the surrounding area to receive all their community-based health services in one centre. Services provided in the centre will include general practitioner services, public health nursing services, community physiotherapy services, social work services, occupational therapy services, chiropody services, dietitian services, learning disabilities services, minor injuries procedures clinic, mental health services including child and family services, physical and sensory disabilities services, psychology services, speech and language therapy services and dental services. The benefits to patients will be the integrated provision of healthcare services centred on patients’ needs and improved local access to services. The new centre will also be used by the community for social activities. The design, construction and procurement of the building were managed by HSE Estates (North West). The building is highly insulated and constructed using low maintenance materials including solar panels, underfloor heating and a ground-source geothermal heat pump. On-site parking will be available for 30 cars.

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News // Dublin north east

+ L-R: Yvonne Corcoran, DCU; Maria Aarts, Founder of the Marte Meo Programme; Dr. Jean Clarke, DCU; Aidan Waterstone, A/Head of Policy & Strategy, National Office of Children and Family Services, HSE; Dr Mel Duffy, DCU; and Colette O’Donovan, Coordinator Marte Meo Training Centre.

+ Staff from the Stroke Rehabilitation Unit (back row L-R): Olive Jones, Helen Ladley, Geraldine Hyland, Shay Englishby, Aileen Rafferty and Christine Watters. Front row (L-R): Marietta Farinais, Edit Moran, Colette Vize, Katie O’Callaghan and Liz Long.

Newly Refurbished Stroke Rehabilitation Unit at Louth County Hospital The Stroke Rehabilitation Unit at Louth County Hospital recently received a complete refurbishment and modernisation to increase its capacity from a six-bed unit to an eight-bed unit. The spacious new unit, which occupies one full ward on the hospital’s first floor, has separate treatment areas for physiotherapy, occupational therapy, speech and language therapy, a cognitive assessment area and a shared facility for a medical social worker and dietician. The ethos of rehabilitation is reflected throughout the unit – a sitting-room or family-room has been designated as a non-clinical area where patients can socialise and engage in a range of activities, which encourage independence building. A special feature of the unit is a self-contained room which has its own separate shower and cooking facilities, where patients nearing discharge can simulate independent living and prepare for life at home. An area adjacent to the unit has also been completely refurbished and it is intended to use this area as a dining area for patients. Patients are transferred from the Acute Stroke Unit in Our Lady of Lourdes Hospital to the Stroke Rehabilitation Unit, where they receive rehabilitation and convalescence in a more appropriate setting.

X-PERT education programme for people with type 2 diabetes X-PERT, the HSE's six-week national group education programme for people with type 2 diabetes, is currently being rolled-out and promoted by community dietitians in Dublin North East. Type 2 is a common chronic condition which causes significant morbidity and mortality if not properly diagnosed and managed. The condition can be treated by making lifestyle changes; following a

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healthy balanced diet, increasing physical activity and losing weight. X-PERT helps people to learn to self-manage their condition and reduce the need for medication. Feedback from participants has been very positive. At a recent programme in Blanchardstown, a participant said that he found it so good that if it had been in Belfast he would have travelled to it. To-date, 28 programmes have been delivered in the north east to 424 clients. For further information contact Siobhán Brennan, Senior Community Dietitian. Tel: (01) 860 4847.

Report for parents of children with communication and developmental difficulties launched The Dynamics of Sharing Professional Knowledge and Lay Knowledge: A study of parents’ and professionals’ experiences of childhood interventions shows the value and importance of the Marte Meo programme as a model of best practice. The report was undertaken by a research team from Dublin City University. The research studied the experiences of families who participated in the programme and the therapists who provided it found that parents developed greater confidence in their parenting skills and rediscovered their ability to parent their child beyond their diagnosis or behaviour problem. Marte Meo is a video-based programme that provides concrete and practical information to parents and carers on supporting the social, emotional and communication development of children, adolescents and adults. The programme offers support and advice for parents of children who are experiencing developmental delay, behavioural difficulties, have a diagnosis of autism, aspergers or ADHD. The HSE Marte Meo Training Centre provides training for health professionals from different disciplines within the HSE and external organisations. For further information contact Colette O’Donovan, Coordinator. Tel: (01) 884 0511; Email: colette.odonovan@hse.ie.

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Dublin north east // News Environmental Health Officers assist with pilot study on Human Biomonitoring Members of the Dublin North East’s Environmental Health Team are involved in a HSE EU-funded pilot study on Human Biomonitoring. Biomonitoring is the measurement of toxins and pollutants in a living person’s system. The purpose of the study, called DEMOCOPHES, is to determine the levels of key environmental pollutants in the Irish population and across Europe. The EHOs recently visited Castleknock Educate Together NS, one of the first Irish primary schools to participate in the pilot study to speak to the staff and children about the study. The project will involve collecting hair, urine samples and data from 120 motherchild pairs in each participating country across the EU. The EHOs are working with the Department of Education and a number of primary schools, half in Dublin and half in Leitrim to facilitate this. The gathered information will help build a picture of the levels of environmental pollutants in people, and this study will form the baseline for future biomonitoring studies with Ireland and Europe. For further information, visit www.hse.ie/go/democophes or www.eu-hbm.info/democophes. + Back row (L-R): Gemma McGrane, EHO; Sean Browne; Anita Larini, EHO. Middle row (L-R): Anna Emelianova; Aedin Ni Thuathail, School Principal; Madeleine Eyzat. Front row (L-R): Grace Flanagan and Mathew McCormack.

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+ Dr Richard Farrell, Consultant Gastroenterologist and Clinical Lead Endoscopy (right); Dr Claire Smyth, Consultant Gastroenterologist (left); and Anna Tarleton, A/CNM1 (left) with staff from the Endoscopy Department pictured at the official Endoscopy Department at Connolly Hospital, Blanchardstown, Dublin.

Endoscopy Department at Connolly Hospital officially opened A new Endoscopy Department at Connolly Hospital, Blanchardstown Dublin, which is one of the largest endoscopy facilities in Ireland, was officially opened in October by Dr James Reilly TD, Minister for Health. Procedures carried out in the unit include upper endoscopy to diagnose and treat common digestive conditions such as acid reflux, ulcers, Helicobacter pylori infection and coeliac disease and routine colonoscopy for the early detection and prevention of colon cancer, as well as diagnosis of inflammatory bowel disease. The department receives over a 100 referral letters every week which are triaged by Consultant Gastroenterologists. In addition to providing Rapid Access Endoscopy Referral for patients presenting to the Emergency Department, the department operates a centralised endoscopy waiting list with all urgent referrals seen within 28 days and the majority of all non-urgent referrals within three months of referral. Selected as one of the initial 15 candidate screening centres for the National Colorectal Screening Programme, the staff are working towards achieving confirmed status as a screening colonoscopy unit by 2012.

New research into the role and benefits of education in drug rehabilitation New research carried out by Martin Keane, Social Research Manager, Health Research Board, shows the positive contribution that education can make for individuals recovering from substance addiction. Twenty people who have progressed through a rehabilitation programme provided by Soilse, HSE Addiction Service in Dublin City Centre were interviewed. To assess their overall recovery, they were asked to talk about early school experiences, the family home, their communities, substance use and addiction, their engagement with treatment and recovery and experiences with education, employment and sustaining accommodation during their recovery. Speaking about his experience of adult education from a social perspective, one interviewee said: “Education introduced me to people that I would never have met before. It gave me a whole new circle of friends, a whole new lifestyle.” A copy of the report, The role of education in developing recovery capital in recovery from substance addiction is available on www.drugsandalcohol.ie.

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News // Dublin north east Mary McAleese visits Knockamann Residential and Day Service Development Last November during her last week in office, the President of Ireland, Mary McAleese, visited the Knockamann development, St Joseph’s Intellectual Disability Service in Portrane, Co. Dublin, where she formally opened the new Knockamann Kafé. The Knockamann Kafé, which is located in the Day Resource Centre, provides opportunities for clients to develop skills such as customer services, handling money, time keeping, food preparation and the opportunity to work towards recognised accredited qualifications. The Knockamann development is a customised residential development, comprising ten bungalows, each with six individual bedrooms and a comprehensive Day Resource Centre. Commissioned in late 2010, 55 clients are now happily settled in their new homes and experiencing a much improved quality of life. Tuas Nua offers the clients an opportunity to participate in cooking and baking activities. The Knockamann Kafé is an extension of this therapy and an integral part of the Day Resource Programme. It is envisaged, in the spirit of integration, that staff will avail of this facility together with clients, their families and visitors. + L-R: Ann McKenna, staff member; Damien Cullen, client; Siobhan Farrell, staff member; Linda Kavanagh, staff member; Teresa Lennon, client; and Gerry Clail, client, pictured with Mary McAleese at the cutting of the ribbon to the new Knockamann Kafé.

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+ Pictured at CAWT ‘Up4IT!’ cross-border obesity conference (front row L-R): Denise McCormilla, CEO, BCCN; Prof. Ferre Laevers, Keynote Speaker, University of Leuven, Belgium. Back row (L-R): Dr Tracy Owen, Consultant in Public Health Medicine, Public Health Agency, Northern Ireland; Julia Moons, University of Leuven, Belgium; and Siobhan Fitzpatrick, CEO, Early Years.

Up4It! Cavan-Monaghan Families Getting Healthy Together Twenty five per cent of children in Ireland are overweight and seven per cent are obese. In response to this the HSE, along with the Border Counties Childcare Network (BCCN) and other statutory and voluntary bodies have developed the Up4It! Cavan-Monaghan Families Getting Healthy Together project. ‘Up4It’, which is an EU-funded CAWT Obesity Project, is now available to families in the Cavan-Monaghan region. The programme is free and is aimed at families who have children aged between eight and 11 years who are overweight according to their body mass index and have no medical cause for being overweight or obese. Information flyers and posters have been distributed to all primary schools, pre-schools and early years’ services, GP surgeries and Primary Care Teams, local health centres, local libraries, family resource and community centres in the two counties. For further information, contact Colette Quigley, Project Coordinator. Tel: 086 730 7304 or email colette.quigley@hse.ie.

73 catering premises in the north east receive Happy Heart Catering Awards A total of 73 premises in the North East have recently received the Happy Heart Catering Awards. The successful catering establishments included restaurants, hotels, pubs and service stations across Louth, Meath, Cavan and Monaghan. Speaking at the event, Jim O’Sullivan, Regional Business Manager, HSE Dublin North East, said: “This initiative is to be commended for highlighting the important role caterers can play in improving nutritional health. It’s tremendous that the caterers honoured today have not only sought to attain the highest standards of food hygiene, they’ve also aimed to attain the highest standards in relation to nutrition too.” Dr Nazih Eldin, Head of Health Promotion, spoke about the significance of the award from a health promotion perspective: “The Happy Heart Catering Award compliments other programmes aimed at combating obesity, in that it creates a supportive environment that enables individuals, families and children to make healthy food choices in a healthy environment. It supports other health promotion initiatives aimed at obesity prevention and management.”

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Dublin north east // GALLERY

+ The Community Nursing Unit in Navan was officially opened in June. The day’s activities commenced with Michael Smith, Bishop of Meath, saying mass for the residents and their families. (L-R): Lydia Mulvaney, Susan Faulkner, Brendan McConnell, Rita Sheridan, Brendan Cully and Ruth Browne. Front row (L-R): Paul Powderely, UnaCarolan, Frances Flynn, Paddy Cunningham, Mary O’Hare, Patricia Greville and Ray Flynn at Beaufort House.

+ Clients and staff from the Cottage Day Hospital, Drogheda Services for Older People were privileged to be invited to attend a farewell party for President Mary McAleese and her husband Senator Martin McAleese in Áras An Uachtaráin on Election Day, October 27th. L-R: Sarah Mallon, eldest client; Margaret Rath, client; Geraldine Matthews, Assistant Director of Nursing; Patricia Collier, Clinical Nurse Manager; Martin McAleese, Senator; Mary McAleese; Mary Everitt, Care Attendant; Dympna Robbins, Director of Nursing; Tom Brady, client; and Enda White, driver.

+ Residents, relatives and staff attending this year’s annual garden at Clarehaven Home in Glasnevin were treated to a guest appearance by much loved comedian, PJ Gallagher. The star of Naked Camera proved very popular amongst those who attended with residents eager to have their photos taken with him. Bridie Smallhorne, resident, is pictured here with PJ.

+ As part of the countdown to Our Lady of Lourdes Hospital becoming a Tobacco Free Campus in February, 2012, staff from the Health Promotion Department recently held An Information Awareness Event for members of the public and staff to give information on the introduction of the new policy and supports available to those who would like to quit. L-R: Laura Thur, Student Nurse; Jane Shields, Smoking Cessation Nurse Specialist; Rose Byrne, Health Promotion Manager; and Nicola Matthews, Student Nurse.

+ The Drogheda Cancer Research & Education Trust at OLOL, Drogheda was presented with a cheque for s25,000 raised at this year’s ‘Dip in the Nip’. The fundraisers organiser, Marie Garvey, is pictured presenting the cheque to Liz Summersby and Dr Bryan Hennessy, Consultant Medical Oncologist. Behind are the ‘dippers’ from OLOL Kathleen Murray, Dara McGeough, Marie Gilchrist, Grainne Mooney and Deirdre Peters.

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News // Dublin mid-leinster

“Shaping a more cost-effective and efficient health service delivery is the major challenge and calls for leadership of the highest order. Any resulting reform must be radical and cannot be built on a service model that is no longer fit for purpose,” believes Richard Dooley, President of Health Management Institute of Ireland (HMI). Leading speakers, who are shaping the health services here and abroad, discussed the policies, processes and practices which have proven successful at a daylong conference, organised by the HMI, in Farmleigh in October. The topics discussed included: ‘New policies… new practices’, ‘What policy imperatives will shape strategic decision making?’ and ‘What can we learn from developments in funding and service delivery across Europe?’. Mr Dooley told delegates: “The HMI applauds the outstanding achievements of health service managers in delivering more with less, and in driving forward for the benefit of our patients with service initiatives in a time of serious financial constraint. The major healthcare challenge is forever present and is common to health service managers elsewhere in the developed world and to public service managers at home too. The challenges in the Irish context however are particularly severe and are challenges to which all health service managers are facing up to. Ongoing and formalised professional development of managers is the strategic investment now required to ensure service solutions for the future that meet the needs of our patients, the requirements of Government and that can be sustained.” The conference was opened by Dr James Reilly TD, Minister for Health.

Embracing reform requires investment in leadership

HEALTHY FOOD MADE EASY PEER LEADER MANUAL Healthy Food Made Easy is a six-week programme designed to help people understand the principles of healthy eating and give them the practical skills to include healthier food every day. e m An updated Peer Leader Manual was launched at a training day o oc on September 14th for Healthy Food Made Easy Peer Leaders in t ge HSE Health Promotion in Tallaght. a im Preparing and cooking healthy meals is a key aspect of the programme. Community dieticians train members of the community as Peer Leaders to deliver the course to groups in their locality. Launching the new Peer Leader manual, Dr Nazih Eldin, Health Promotion Functional Manager, Dublin North East, welcomed it as a resource which will enhance the experience of Peer Leaders and participants on Healthy Food Made Easy courses. He said: “Promoting healthier eating habits in the population is a key strategy in reducing chronic disease. A balanced diet reduces risk of obesity, cardiovascular disease, diabetes and certain cancers. In addition to information, people need practical skills to make and sustain dietary changes.” He also praised the work of all Healthy Food Made Easy Peer Leaders who, over the last ten years, have delivered the programme to around 15,000 people nationally. Each of these participants has taken new knowledge and skills back to their households. Dietician manager Margaret O’Neill acknowledged the work of community dieticians in producing the resource. A working group of dieticians, led by the team in Tallaght, drew on expertise from around the country to produce a resource of outstanding quality. The Healthy Food Made Easy programme is available in Dublin, Kildare, Wicklow, Longford, Westmeath, Laois, Offaly and Cork. For information contact your local Community Dietitian.

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Dublin mid-leinster // News Stroke group proving vital support in Killinarden

+ L-R: Michael Knowles, General Manager, Alice Kinsella, Clinical Services Manager; Sr Mary Lalor, End of Life Co-ordinator; Ger Hogan, Assistant Treasurer of Friends of Naas Hospital; Barbara Fitzgerald, Director of Nursing; Mary Byrne, Treasurer of Friends of Naas Hospital; Sheila O’Connor, Chair of Friends of Naas Hospital, Bernie McMahon, GP Liaison Officer; and Helen Buckley, Assistant Director of Nursing.

Naas General Hospital Staff in Naas General Hospital are very conscious of the importance of the last days of life for people who are dying, as well as their friends and relatives. In 2007, Naas became one of the first hospitals to be involved with the ground-breaking Hospice Friendly Hospitals (HFH) programme, which is the first such national end-of-life care initiative in Europe. The initiative has had a number of practical effects, including the introduction of family handover bags, which have taken the place of a plastic bag for the personal effects of the deceased patient. A trolley drape with a spiral symbol is now used to facilitate the respectful removal of a deceased person from the ward to the mortuary and a refurbishment of the mortuary also took place. “It is a day-to-day education for everyone involved in such a sensitive area,” explained Sr Mary Lalor, pastoral care worker and the hospital’s End-of-Life Co-ordinator. “It raises awareness, not just amongst those directly involved, but also all hospital staff and the public. What has been done is to make the whole process very inclusive,” explained Sr Mary. Following a HFH national audit of hospitals in 2010 further areas of improvement were identified. A recent project involved designating private rooms for family and friends of patients. The hospital’s Director of Nursing, Barbara Fitzgerald said: “This is a worthy cause that’s not often spoken about. Education around this area is starting to happen but it needs to be opened up further.”

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A community Primary Community and Continuing Care (PCCC) team in Tallaght has worked in conjunction with AMNCH hospital to set up an initiative for stroke survivors. The stroke support group was set up earlier this year by the Killinarden Primary Care Team and is now up and running in Tallaght. On average, more than thirty stroke survivors and carers attend the monthly group meetings. The group provides a transition between hospital and home and offers a support service which can help to reduce the feeling of isolation back in the community. In addition, it provides a social outlet to increase interaction and allow people to meet others in similar situations. The stroke support group began as a Killinarden primary care initiative and their first meeting was held in January 2011. Anne Marie Kiely, Senior Occupational Therapist at Mary Mercer Health Centre in Tallaght explained: “As a group they provide each other with shared information, but more importantly with emotional support and motivation to cope with the challenges that their diagnosis has created. The stroke support group provides an opportunity for stroke survivors to support each other.” The group is currently run on the last Wednesday of each month in the Killinarden Community Centre in Tallaght from 11am to 1 pm. The group caters for all ages and stages of life, including family members, carers and friends. Next year the group will be located in the conference room in Tallaght Library, with the first meeting in January on Tuesday 17th from 11am to 1pm. The initiative was initially set up by Niamh Barrett Senior Speech and Language therapist, Anne Marie Kiely Senior Occupational therapist and RGN Mary O’Connor. The group also had help from Tallaght Hospital’s Acting Clinical Nurse Specialist in stroke care Deborah Fitzhenry and met with the Multidisciplinary Team in Tallaght Hospital including the Stroke service Consultants Professor O’Neill, Dr Ronan Collins and Dr Tara Coughlan before the roll out of the group. Those who also have come on board include; Anne Marie Peters and Jessica O’Dowd HSE Physiotherapist’s and Nicola Cogan Stroke Specialist Nurse, Tallaght Hospital.

+ L-R: Niamh Barrett, Padraig Allen, Anne Marie Peters and Sheena Heffernan.

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Speech and Language Supports as an Early Intervention Strategy Early intervention speech and language supports are central to helping a child’s development. A range of innovative responses to child and family needs have been delivered in Tallaght West over the last three years through the Childhood Development Initiative (CDI). The initiative is a collaboration between the Department for Children and Youth Affairs (DCYA) and the Atlantic Philanthropies. One of the responses put in place is an early intervention speech and language strategy. Following extensive consultation with those living and working in Tallaght West, CDI identified the need for speech and language interventions with young children. However, it was apparent that there was a need for a new approach to delivery. High levels of non-attendance for assessment were a significant concern within the HSE service. Early years practitioners and school principals also recognised the need for enhanced professional development in this area. A three-pronged approach subsequently emerged, incorporating: Individual child assessments and therapy; accredited training for teachers and early years practitioners; and parent education programmes. A partnership was created locally to support the delivery, incorporating employment through An Cosan, (a local education centre) and the HSE, who provide role supervision and important professional linkages. The CDI provided funding and monitoring and the approach is being independently evaluated by Dublin Institute of Technology (DIT). For further information, please contact: Jennifer Grundulis, Senior Speech and Language Therapist at jennifer.cdislt@gmail.com; Michelle Quinn, Speech and Language Therapist at slt. healthyschools@gmail.com; or Gráinne Smith, CDI at grainne@twcdi.ie.

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The parentingsupport.ie website offers valuable assistance to both parents and professionals in Kildare and west Wicklow. The website gives information about parenting programmes and courses that are available locally. You can search parenting programmes on the website by name, location, theme or age group of children and information about different parenting programmes can also be accessed. The parentingsupport.ie website is an initiative of the multi-agency Kildare West Wicklow Parenting Training and Support Forum. It has been funded by Co. Kildare LEADER Partnership and Kildare County Childcare Committee. This initiative is supported by Kildare Children’s Services Committee.

Over 150 people attended stress control classes in Athy and Newbridge in September and October and further classes are now being planned for Naas in January and Baltinglass in February. The HSE Psychology Service in Kildare and West Wicklow delivered the classes with support from a number of agencies. Kildare-based psychologists Dr Gary Collins, Dr Deirbhile Lavin, Dr Tonya Madden and Dr Rosario Power delivered the six-week training programme after they trained with Jim White, a clinical psychologist from Glasgow who initially developed the stress control classes. The classes addressed the following areas: information about stress, relaxation, exercise, learn to think your way out of stress, boost self confidence, control panic and controlling sleep problems. Dr Rosario Power, Senior Clinical Psychologist, said: “The response from the public was amazing from the outset. Once the media campaign began there were more than 200 texts from people expressing an interest in attending. Some of those who struggled to get the courage to attend earlier sessions were pleased to report having successfully attended for later sessions. In addition to the direct benefits to those who attended the classes, a number of those who attended took extra materials and CDs to give to family and friends whom they knew to be experiencing difficulties.”

www.parenting support.ie is launched

Members of public flock to stress control classes

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Dublin mid-leinster // Gallery

+ Laois native and new mum Oonagh Lawler supports National Breastfeeding Week which was held from Saturday October 1st to Friday October 7th. At the Midland Regional Hospital at Portlaoise new mum Oonagh Lawler with her baby girl Catherine was delighted to support HSE Breastfeeding Week and urge mothers to ‘Give your baby the best start in life’. Oonagh is pictured with Terry Cotter, Clinical Midwife Specialist lactation and Anne Duff, Staff Midwife. National Breastfeeding Week was held from Saturday October 1st to Friday October 7th.

+ Children First Guidance 2011. Back (L-R): John Lee, Principal Dental Surgeon, Laois/Offaly; Michael Mulcahy, Principal Dental Surgeon, Longford/Westmeath; Pat Osborne, Child Care Manager, Laois/Offaly; Fionnuala Greening, Training Officer; and Maria Larkin, Child Care Manager, Laois/Offaly. Front (L-R): Gerry O’ Dwyer, Regional Development Officer, HSE Dublin Mid-Leinster; Frances Fitzgerald, Minister for Children; and Gordon Jeyes, National Director, Children and Family Services, HSE.

+ The opening of a memorial garden marking the service of deceased ambulance service members, which has been opened at the HSE NAS Loughlinstown Ambulance Station in Shankill, Co. Dublin.

+ Josephine Rigney (second from left), HSE Suicide Resource Officer for the Midlands is pictured with (L-R) Noel Joyce, Angela Mahon (both Designhub), Niamh Dowler, Offaly County Council and Tom Finnerty, Offaly Community Forum Chairperson.

+ Orlagh Claffey has been appointed Hospital Manager of the Midland Regional Hospital at Tullamore. Orlagh is qualified as a radiographer from the University College Hospital of Wales in 1993. She worked as the Quality and Accreditation Manager in the Midland Regional Hospital at Mullingar and Tullamore respectively. In 2008, Orlagh achieved a Masters of Business Administration in Athlone Institute of Technology.

+ HSE supported project wins permanent TSB Foróige Youth Citizenship Award. The Attic Youth Project in Longford Town provides the opportunity for local youth to access a range of tailored services and programmes aimed at increasing their ability to take increasing control over those things that are impacting on their health and wellbeing.

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News // soutH new PoDIaTry serVICe In kerry

+ attending the graduation of the Hse south’s self-harm reduction programme were (l-r) Dr Nataraj Gojanur, Consultant Psychiatrist; Barbara shorten, art therapist; Dr Mary Kells, a/senior Clinical Psychologist; Daniel Flynn, senior Clinical Psychologist and Programme leader; sinead Boyce-Greaney, Clinical Nurse specialist; James O’ Mahoney, advanced Nurse Practitioner, Psychotherapy; and Gretta Crowley, Operations Manager, Hse south.

serVICe Users CeleBrate COMPletING NeW selF-HarM reDUCtION PrOGraMMe tWelVe serVICe Users from the Hse south’s North lee adult mental health services in Cork recently completed a new self-harm reduction programme, called the ‘endeavour Programme’. the graduates have been diagnosed with borderline personality disorder (BPD), which is recognised by its key features of difficulties in managing emotions, continual self-harm and repeated suicidal behaviour. they have been learning how to cope with these difficulties through intensive individual therapy and by learning alternative healthy coping skills and behaviour. the endeavour programme is an evidence-based treatment using dialectical behaviour therapy (DBt), a treatment developed by Dr Marsha linehan, a Us-based clinical psychologist. the treatment is comprised of group skills training, individual therapy and phone coaching to help clients let go of self-destructive behaviour and improve their quality of life.

your gooD selF – a reaDIng Programme on keePIng well emoTIonally tHere Is GOOD eVIDeNCe that information helps people to understand their emotional health and gives them practical ideas to try and improve their emotional well-being. resources on emotional well-being are now available at Mallow library including books, cds, dvds and lists of websites. the resources are practical and helpful and cover a variety of topics including parenting, stress management and self-esteem. lists of these materials are available in the library and can also be accessed through local GPs, health professionals, teachers and other individuals working in the community. the lists will also be available on the Hse and Cork County library websites. Clinical Psychologists Dr rosarie Crowley, Dr. Catherine Maguire and Dr Nicola lally, based at Mallow Primary Healthcare Centre, identified a need to provide quality information to the people of north Cork on how to look after their emotional well-being as part of their overall health. In cooperation with the Cork County library and arts service this community based initiative, Your Good self, the North Cork Positive self Help Programme, which is the first of its kind in north Cork, was launched in October.

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tHe Hse aPPOINteD two new senior podiatrists for Kerry in conjunction with the Diabetes Federation of Ireland, marking the first phase of a new podiatry service for Kerry. the two new podiatrists, tricia Casey and Jan Cumiskey, commenced duty in July and have been working closely with the multidisciplinary team in both the hospital and community setting providing education and training sessions for hospital staff, GPs, practice nurses and primary care team members. the Hse Diabetic Foot Care Integrated Programme identified a need for a podiatry service in Kerry. the new service is a welcome additional support to the existing health service providers in delivering the most appropriate care for clients in Kerry with foot-related conditions the podiatrists will also further enhance the existing diabetic service in Kerry, which has been developed in recent years with the provision of three dedicated consultant-led diabetic clinics held monthly at Kerry General Hospital and 28 specialist diabetic nurse-led outpatient clinics monthly held in communities throughout the county.

+ Jan Cumiskey, Podiatrist, Kerry Community services, with Dr tom Higgins, Consultant Physician, Kerry General Hospital and Helen Crowley, Diabetes Nurse specialist, Kerry General Hospital at the announcement of the new podiatry service for Kerry.

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South // News Mallow Health Centre initiative breaks new ground in patient care

+ L-R: Sheena Cadoo, Occupational Therapist, North Cork and Liz Kelleher, Alzheimer Society of Ireland, North Cork

Cormac Sheehan (PhD), Senior Research Officer at the Mallow Primary Healthcare Centre (MPHC), is working on a new initiative that has the potential to save the HSE thousands of euro each year. The research post, funded by the HSE has enabled Sheehan to work with GPs at the centre to build up profiles of each patient’s individual healthcare requirements. 1,100 elderly patients registered at the centre were sent questionnaires about basic health issues in a bid to identify their particular care needs. This work, carried out under the EARLI (emergency admission risk likelihood index) Interventions Programme will allow GPs to identify high risk patients who would be most likely in need of emergency hospital departments. This would ease pressure on A&E departments, reduce waiting times and save money. Secondly, and just as important, is that it will allow various health professionals within the centre the opportunity to work together to assess the needs of patients and provide presentative care when needed. This programme demonstrates the efficacy of joint working in primary care. In September, the HSE and Alzheimer Society of Ireland came together and set up a stand in the foyer of the Mallow Primary Healthcare Centre to mark World Alzheimer’s Day. This year it was ‘faces of dementia’.

Building Sexual Health Promotion Capacity The Foundation Programme in Sexual Health Promotion (FPSHP) is the cornerstone of the sexual health capacity-building strategy of the Health Promotion Department, HSE South, and is an example of the synergy created through successful collaboration between staff of the former South and South-East regions. Following a regional feasibility study, the programme was developed in response to the scarcity of ‘training for trainers’ courses of sufficient breadth and duration to develop the sexual health promotion capacity of health, education and community professionals. The FPSHP takes a broad, holistic approach to sexual health and, informed by national and international research, the programme seeks to increase participants’ knowledge, skills and self awareness in relation to sexual health. Participants explore a range of topics with a view to translating the learning into sexual health promotion in their workplaces. This is facilitated by the availability of post-training support.

+ Kerry Graduates of the FPSHP 2011.

Minister for Health Officially Opens Ayrfield Primary Care Centre, Ayrfield Medical Park in Kilkenny City

A new Primary Care Centre and Medical Park was recently officially opened in Kilkenny by Dr. James Reilly TD, Minister for Health. Ayrfield Primary Care Centre features GPs and practice nurses attached to the former Dean Street Medical Centre, working as part of a Primary Care Team with a range of HSE health professionals including public health nurses, physiotherapists, speech and language therapists, community mental heath nurses, occupational therapists, dieticians and administration. Ayrefield Medical park will also provide hospital based services at local level, such as exercise stress tests for diagnosis of heart disease, as well as facilities for infusions and intravenous treatments. The Ayrfield Primary Care Team is a multidisciplinary group of health and social care professionals in Kilkenny city who manage and deliver primary care services to the local population. + Pictured during the Minister for Health’s tour of the Ayrfield Medical Park in Kilkenny, during its Official Opening were (from left to right): Lorna Raggett (Senior Occupational Therapist, Ayrfield Primary Care Team), Anna Marie Lanigan (HSE Area Manager, Carlow-Kilkenny/South Tipperary), Pat Healy (Regional Director of Operations, HSE South) and Minister for Health Dr James Reilly TD.

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NEWS // SOUTH Steps towards a modern, quality and responsive mental health service + Dr. Frank Dolphin, Interim Chairman of HSE Board, Hamilton Goulding, CRC Chairman, Zach Winters and Muireann Nolan.

New Central Remedial Clinic facility in Waterford officially opened The Central Remedial Clinic (CRC) premises at Waterford Regional Hospital was officially opened by Dr. Frank Dolphin, Interim Chairman of the HSE Board. Representing a joint investment of s5.4 million by the HSE and the CRC, the new centre greatly enhances services for children with disability in counties Carlow, Kilkenny, South Tipperary, Waterford and Wexford. Regional assessment services to all children with physical disability in the South East region will be provided from the centre. Currently, up to 600 clients are availing of the services. In addition to the main departments, the clinic will also provide a number of specialist clinics and its cutting-edge design will provide the CRC the potential, in the future, to allow for further development of additional specialist clinics and services in the South East.

s20 million Capital Development at Wexford General Hospital Brendan Howlin TD, Minister for Public Expenditure and Reform, + Minister Brendan Howlin TD taking a tour through Wexford General Hospital with Pat Healy, Regional Director of Operations, visited Wexford General Hospital HSE South, Dr Colm Quigley, Clinical Director, WGH and Lily (WGH) to mark out of the site Byrnes, General Manager, WGH. to commence the s20m capital development. This capital development will incorporate a new Emergency Department, Concourse and Maternity Theatre/Delivery Suites. The s20 million allocation, which features in the HSE’s Capital Plan, will fund the construction, fitting-out and equipping of the new development at WGH. Upon completion, the new ED will provide a total of 17 treatment spaces for emergency patients – an increase of 13 treatment spaces on the four currently available. This significant expansion in capacity will lead to improved admission times for patients and enable WGH to comply with Minister James Reilly’s Special Delivery Unit guidelines. The new ED will also provide a much enhanced environment for patients and for the staff working in the Department. The current Maternity Theatre/Delivery Suite, to be replaced as part of the new capital development. The project includes the demolition of the existing Delivery Suite, with two new constructions over three floors.

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The key element of the HSE South’s Programme for implementation of 'A Vision for Change' in Carlow, Kilkenny and South Tipperary Mental Health Services is to enhance and develop community mental health services and enable the service user to remain in the community to the greatest extent possible. HSE South has prioritised the implementation of the change programme and has allocated more than s20m capital funding and over s1.75m revenue funding to support this comprehensive development programme. The programme heralds the enhancement and development of community mental health services, the closure of old long-stay institutions, the separation of North and South Tipperary acute inpatient mental health services and development of appropriate acute inpatient services, for the extended catchment area, in line with the national strategy for mental health A Vision for Change. The programme also acts on recommendations of the Mental Health Commission.

+ Anna Marie Lanigan addressing a recent briefing for HSE staff members on the next phase in implementation of 'A Vision for Change' in Carlow, Kilkenny and South Tipperary Mental Health Services. Seated at her right are fellow panelists at the briefing (L-R): Damien Godkin, (National Service Users Network); Pat Healy, HSE South; Dr. Frank Kelly, (Executive Clinical Director Carlow, Kilkenny, and South Tipperary Mental Health Services), Joe Mooney (Director of Nursing), South Tipperary Mental Health Services; and Barry O’Brien. (Assistant National Director of Human Resources/HSE South)

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South // GALLERY

+ Three Information sessions to introduce a booklet for Home Help and Personal Assistant Coordinators, Community and Public Health Nurses were provided by Infection Control Nurses in Cork and Kerry recently. L-R: Roberta Tobin, Public Health Nurse, North Cork Community Care; Sharon Lyne, Cork Centre for Independent Living; Deirdre Murphy, Cheshire Ireland and Vicky Chan, Cork Centre for Independent Living.

+ Many staff in the HSE identify opportunities to improve the quality of care for their patients and ensure patient safety. The Quality and Patient Safety conference highlighted projects that have been completed by participants in MUH’s Clinical Outcomes. L-R: Denise McCarthy, HSE South QPS; Marie Kehoe, HSE South Regional General Manager, QPS; and Elizabeth Myers Nurse Tutor Coordinator at Mercy University Hospital (MUH).

+ St Finbarr’s Hospital Nursing services and the Department of Old Age Psychiatry, South Lee recently held their joint second Conference on Dementia Care. There were again prominent speakers to include Professor W. Molloy, Consultant Geriatrician, Prof. Tony O’Brien, Consultant Palliative Care; Prof. Cillian Twomey, Consultant Geriatrician, Joan McCarthy, Professor of Ethics; Ms. Mary J Foley, Advanced Nurse Practitioner – Rehabilitation of the Older Adult; as well as Professor Geri R Hall, University of IOWA Memory Clinic, USA who returned again this year by popular demand.

+ National Poetry Day was celebrated at Waterford Regional Hospital (WRH). Pictured back row (L-R): Brian Kennedy, (Orthopaedic Nurse, WRH); Ann Ellis, (Assistant Director of Nursing, WRH); Liz Moran, (Occupational Therapy Manager), WRH; Eoin Barry, (HSE Procurement); and poet Mark Roper. Front row ( L-R): Mary Grehan, (Arts Director, Waterford Healing Arts Trust); Karl O’ Sullivan, (Purchasing, WRH); Paula Curtin, (Assistant Director of Nursing/Maternity & Paediatrics); Lila Kelly, (outgoing Director of Nursing, WRH); and Hazel Daniels, (retired Director of Nursing, WRH).

+ Patients at the new state of the art Stroke Unit at Waterford Regional Hospital WHR are to benefit from a donation of new beds purchased by the Friends of Waterford Regional Hospital Committee. L-R: Susan Cliffe, (Acting Assistant Director of Nursing for Medical Services); Ingrid Diegmann, (Friend of WRH); Siobhan Vereker, (Staff Nurse, Stroke Unit); and Friends of Waterford Regional Hospital Committee members Elizabeth Morrissey, Mary Carroll, Ann Harrison, Joan Matson, Mary O'Halloran and May Lanigan.

+ A seminar on the ‘Challenges in Research Ethics’ was hosted by the Nursing Dept., School of Health Sciences, Waterford Institute of Technology. Back Row (L-R) Dr Mark Doyle, (Consultant in Emergency Medicine), Dr Brian Creedon, (Consultant in Palliative care), Grace Cunningham, (Research Ethics Manager HIQA), Prof David Smyth, (RCSI). Front Row (L-R) Valerie O Donnell, (Senior Speech and Language Therapist), Caroline Lamb; (Research Ethics Coordinator HSE-SE), Teresa Boland, Midwife and Dr Paula Lane, (Chairperson, HSE Research Ethics Committee/Lecturer).

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News // west New Department of Psychiatry Admissions Unit in Donegal

+ Pictured during a rheumatology telemedicine clinic at Roscommon County Hospital (RCH) with Dr Robert Coughlan, Consultant Rheumatologist, Merlin Park University Hospital (on-screen) are (L-R): Margaret Jordan, Clerical Officer, Roscommon County Hospital; Anne Varley, CNM2/OPD, Roscommon County Hospital; Philomena Kelly, Castlerea (seated); and Margaret Tighe, Staff Nurse, OPD, RCH.

Launch of New Rheumatology Telemedicine Out-Patient Service between Roscommon County Hospital and Merlin Park University Hospital In 2008, the European Commission launched an initiative to improve the access of patients in remote areas to high quality healthcare. One of the key parts of this initiative involved the use of ‘telehealth’. In 2009, Dr Robert Coughlan, Dr John Carey and the rheumatology team in Merlin Park University Hospital commenced a research programme to examine the utility and feasibility of a telemedicine service. The research was funded by a grant from Abbott Laboratories (Ireland) Ltd. Following a number of refinements, the team in Merlin Park University Hospital linked up with a team in Roscommon County Hospital and, after further refinements and adjustments, the first definitive telemedicine clinic was conducted in Roscommon County Hospital in October 2011. Patients from the Roscommon area attended RCH and were seen and interviewed by the rheumatology team in Merlin Park University Hospital via the telemedicine service, and appropriate advice was given and adjustment of treatment was made, where necessary. Commenting on the new initiative, Dr Coughlan said: “I have been conscious of the distance that some review patients had to travel to come to my clinic in Galway. Following discussions with staff in Roscommon County Hospital we have put a facility in place that has allowed us develop a telemedicine service. This is initially being done on a pilot basis and allows me to discuss and review a patient’s condition with them via a computer link.”

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Kathleen Lynch, TD, the Minister of State for Disability, Equality, Mental Health and Older People, officially opened the new Department of Psychiatry Admissions Unit on the grounds of Letterkenny General Hospital in September. The Department of Psychiatry Admissions Unit, which is part of Donegal Mental Health Services, has 34 beds offering in-patient care to service users over 18 years of age, along with mother and baby accommodation and facilities that are specifically designed to accommodate people over 65 with particular mental health needs. In addition, it has fully equipped recreational and occupational therapy departments, along with administration, treatment, teaching and tribunal facilities. The new unit is a single-storey building with a floor area of approximately 1,790m2. Construction started in March 2010 and the project cost s5.95 million. The new unit will support a comprehensive integrated mental health service for a defined catchment area of approximately 145,000 people. John Hayes, HSE Area Manager for Donegal, said: “The opening of the new unit is a great step forward in the delivery of mental health services in Donegal. In addition to the new unit we have a community mental health team located in the primary care centre in Letterkenny; a new base was established in Donegal town for child and adolescent services in the past 18 months; and rehabilitation services were established. These developments are a tribute to the HSE staff in the mental health services and their drive to modernise and de-stigmatise mental health services. The common goal is simply to provide the best service in an environment that promotes recovery and wellbeing for patients who use the service.” + Pictured at the opening of the Department of Psychiatry Admissions Unit in Donegal are: (back row L-R) Eugene McElroy, Business Manager for Mental Health & Intellectual Disabilities; Hugh McDaid, Unit Manager; Michael Martin, Project Manager; (front row, L-R) Kevin Mills, Director of Nursing, Donegal Mental Health Services; John Hayes, Integrated Services Manager, HSE Donegal; Kathleen Lynch, Minister of State for Disability, Equality, Mental Health and Older People; and Dr Cliff Haley, Clinical Director, Donegal Mental Health Services.

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west // News Letterkenny General Hospital launches End of Life Care Pack Letterkenny General Hospital recently launched an End of Life Care Pack at the hospital, including the End of Life symbol, which aims to add respect and solemnity to items and environments used following the death of a person. The End of Life Care Committee also + The End of Life Care Committee at the launch of the End of Life Care Pack at Letterkenny General Hospital. launched other practical resources, Back row (L-R): Eamonn McNulty, Senior Mortuary Technician; Claire McAleer, Assistant Director of Nursing, including sympathy cards, End of Life Medical Services; Mary Friel, End of Life Care Coordinator; Cllr Paschal Blake; Eileen Egan, Quality & Risk Care resource folders for clinical areas, Department; Noreen Harley, Assistant Director of Nursing. Front row (L-R): Evelyn Smith, Assistant Director of Nursing and Dr Anne Flood, Director of Nursing and Midwifery Services, LGH. information booklets, staff development DVDs for End of Life Care and the Ethical Framework for End of Life Care. The hospital has already introduced some of the resources, including a patient handover bag, mortuary trolley drapes and a ward locker, all with the End of Life symbol clearly displayed. Speaking at the launch, Mary Friel, End of Life Care Coordinator at Letterkenny General Hospital, said: “Our intention is to raise awareness amongst staff of the work which has been undertaken at the hospital around End of Life Care and the importance of dignity and respect for patients and their families at this difficult stage of life.” She added: “We will be introducing the End of Life spiral symbol in clinical areas, for example at the nurses' stations, to signify that a patient is very close to death or has recently died. This will indicate to visitors and staff that an intensely personal and profound event has happened or is happening for the patient and their family. The three-stranded white spiral represents the cycle of birth, life and death and is inspired by ancient Irish history without any association to any religion or denomination.”

Galway Public Health Nurses graduate from the NCCP Community Oncology Nurse Programme Dr Susan O’Reilly, Director of the National Cancer Control Programme, presented the Galway Public Health Nurses who graduated from the NCCP Community Oncology Nurse Programme with certificates at a ceremony in October. The six-month training programme was An Bord Altranais Category 1 approved and was delivered through the Centre of

Nursing and Midwifery Education. It included classroom-based theory, the development of clinical skills under supervision and the application of these skills in the community. Among the services and care that nurses will now be providing in their patients’ homes are the taking of blood samples and the maintenance of patient equipment.

+ The NCCP Certificate presentation. Back row (L-R): Michelle Mylotte, La Nua, Ballybane; Marie Kirwan, Mountbellew Health Centre; Irene Fahy, Carna Health Centre; Christina Kelly, East City Primary Care Centre, Doughiska; Mary Day, Headford Health Centre; Fiona Dixon, Gort Health Centre; and Bríd McHugh, Tuam Health Centre. Front row (L-R): Olivia Byrne, Shantalla Health Centre; Mairead Kirk, East City Primary Care Centre, Doughiska; Mary Connell, Shantalla Health Centre; Dr Susan O’Reilly, Director, National Cancer Control Programme; Sharon Linnane, Mervue Health Centre; and Mairead Walsh, Spiddal Health Centre.

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News // West

new PrImary Care CenTre In ballIna

+ Ballina Primary Care Centre staff with an taoiseach, enda Kenny, tD, at the official opening in October.

aN taOIseaCH, eNDa KeNNY, tD, opened the new Ballina Primary Care Centre in October. the new centre, on Kevin Barry street in Ballina, is the first of its kind in County Mayo. the Hse staff based at the Primary Care Centre (coming from both existing and newly appointed staff) include Public Health Nurses, a registered General Nurse, a Dietitian, a Home Management advisor, an Occupational therapist, staff from the National adult Counselling service, Physiotherapists and a speech and language therapist. staff members also include the existing GP practice of Dr sean Moffatt, Dr tom Moffatt, Dr Maura Irwin and Dr James Harrison, as well as the practice of Dr Michael Moffatt and Dr Danuta smietanka. all of the Hse services based at the new centre are available to the entire population of Ballina, including those attending other GP practices in the town. speaking at the official opening, an taoiseach said, “the Government agenda is to place emphasis on primary care and this centre is part of the Hse development programme. I wish the multidisciplinary team here every success for the future”. laverne McGuinness, Hse National Director, Integrated services Directorate, added, “Primary care health services are the first point of contact for people and include services such as GPs, Public Health Nurses, Physiotherapists, Occupational therapists, speech and language therapists, Practice Nurses, Home Helps and Primary Care Dietitians. this Primary Care Centre will allow the public to have easy access to an increased range of services based in the one location, close to home.”

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+ Pictured at the opening of the Ballina Primary Care Centre are (l-r): Martin O’Halloran, O’Halloran Consulting; John Hennessy, rDO West; Dr. tom Moffatt; an taoiseach, enda Kenny, tD; Deputy Michelle Mulhern, tD; laverne McGuinness, Hse National Director, Integrated services Directorate; Dr. sean Moffatt; Martin Greaney, General Manager, Mayo PCCC; Dr. Michael Moffatt; and Frank Murphy, Hse area Manager, Mayo.

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west // gallery

+ National Breastfeeding Week was celebrated in Sligo at events in Drumcliffe, Riverstown and Sligo town involving expectant and breastfeeding mums, health professionals and voluntary breastfeeding support leaders. In Leitrim, the Ballinamore support group celebrated with a coffee morning in Tráthnóna (pictured above).

+ In September, Galway University Hospitals was one of the first public hospitals to perform a new device-based procedure – Renal Artery Denervation – for patients who suffer from resistant high blood pressure. L-R: Dr Briain MacNeill, Consultant Cardiologist; Dr Faisal Sharif, Consultant Cardiologist; Dr Sajjad Matiullah, Cardiology Registrar; and Dr Jim Crowley, Consultant Cardiologist.

+ Service users from HSE West Mental Health Services and HSE training centres in County Roscommon held an Organic Garden Day to coincide with National Organic Week in September. The Organic Garden Open Day gave the service users an opportunity to display and sell their home-grown organic produce. L-R: Martin Mullooly and Brendan Dwyer pictured in one of the tunnels at the Organic Garden.

+ Letterkenny Youth & Family Service was awarded the contract to deliver family obesity prevention and management programmes in the area. Funding was secured by the cross-border health services partnership, Cooperation and Working Together (CAWT) from the European Union’s INTERREG IVA programme. L-R: Claire McGinley, Project Manager, CAWT Obesity Project; Garry Glennon, Manager, Letterkenny Youth & Family Service; and Emma Ball, Community Dietetic Manager, HSE West.

+ Three new consultants, Dr Ruth Gilmore, Consultant Haematologist, Deirdre Jones, Consultant Plastic Surgeon, and Orla Young, Consultant Ear, Nose and Throat (ENT) Surgeon, recently joined the consultant team at Galway University Hospitals. L-R: Orla Young, Deirdre Jones and Dr Ruth Gilmore.

+ Residents and clients of St Brendan’s Community Nursing Unit (CNU) and St Martin’s Day Services recently moved into the new Community Nursing Unit, located alongside the former building in Loughrea. The recently completed 100-bed St Brendan’s CNU is a purpose-built facility which provides residents with both single and double en suite bedrooms and fully meets the Health and Information Quality Authority standards. Pictured: Staff from St Brendan’s CNU in one of the day rooms of the new facility.

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08/12/2011 17:00:09

86 Health Matters

News // in brief Website Encourages Us to Get More Active and Improve Our Health

complementary therapy unit in Crumlin

+ Representatives of HSE DNE at the website launch (L-R): Colm Casey, Health Promotion Officer – Physical Activity, Cavan/Monaghan; Dr Nazih Eldin, HSE Lead on Obesity; and Yvonne Gilsenan, Physical Activity Coordinator, HSE Health Promotion.

The website, www.getirelandactive.ie, a one-stop information source on how to get involved in physical activity in Ireland, has recently been launched. With three out of four Irish adults and four out of five Irish children not sufficiently active for health benefits, this website is designed to encourage people to become more active by creating awareness of the range of activities and opportunities for physical activity that exist locally, regionally and nationally; and providing advice on how to get started, tips on how to get more active and motivation to keep them going. The site allows users to search for activities throughout Ireland by type, date, age group, ability or cost, so there is something for everybody to get involved in, from individual and team sports to family-friendly activities.

A new service has started at Our Lady’s Children’s Hospital, Crumlin offering children and their parents a range of therapies to help ease some of their suffering. Thanks to the generosity of the Julie Wren Trust at the Children’s Medical & Research Foundation, the new Complementary Therapy Unit was officially opened by Miriam O’Callaghan at Our Lady’s Children’s Hospital, Crumlin. The service is available to both children & parents attending the National Children’s Haematology & Oncology Centre offering therapies such as aromatherapy, reflexology and Indian head massage on-site. The new facility was funded in totality by the Julie Wren Trust who have provided funding for a half time complementary therapist for five years.

+ Miriam O’Callaghan is pictured giving Jamie Pim (age 12) from Glencullen an Indian head massage at the opening the new Complimentary Therapy Room.

Ruth Achieves Highest Grade Pictured at a recent conferring at NUI Galway was Ruth Kelly from Oranmore, Co. Galway, who was conferred with an Honours Bachelor of Science degree. Ruth was also the recipient of the Dunican Memorial Medal in Microbiology, for achieving the highest grade in the BSc in Microbiology at NUI Galway. Also pictured are (L-R) Dr Gerard Wall, Lecturer in Microbiology at NUI Galway, and Prof. Vincent O’Flaherty, Established Professor of Microbiology at NUI Galway.

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08/12/2011 17:00:30

Health Matters 87

in brief // News Building Sexual Health Promotion Capacity

+ Kerry graduates of the FPSHP 2011.

The Foundation Programme in Sexual Health Promotion (FPSHP) was established by the Health Promotion Unit, HSE South in response to the scarcity of ‘train the trainers’ courses to develop sexual health promotion amongst staff. The programme takes a broad, holistic approach to sexual health and, informed by national and international research, seeks to increase participants’ knowledge, skills and

self awareness in relation to sexual health. Post-training support is provided by the Sexual Health Team, provision of a sexual health resource library in each local Health Promotion Office, and a biannual newsletter featuring the latest national and local sexual health news. Former participants have gone on to implement a range of activities such as policy development, education projects,

Temple Street wins Green Economy Forum Competition + Entrepreneur and green business guru Bobby Kerr, pictured with Padraig Ryan, Sustainability Coordinator, Temple Street Children’s University Hospital, winner of the Green Economy Forum award.

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community-based workshops, the incorporation of the topic within counselling and clinical consultations, and a research project into the sexual health needs of students within a third level institution. The majority of FPSHP participants come from HSE disciplines and all 150 past participants have found the course useful, with 100 per cent saying that they would recommend it to colleagues.

Conference for Healthcare Managers

+ Dr Frank Dolphin, Chair HSE, with Council Members of the Irish Association of Speech & Language Therapists (IASLT) after giving a key-note address recently at their 2011 Conference, from (L-R) Jonathon Linklater, Derval McDonagh, Edel Dunphy, Louise Collins, Marijke Morris, Deirdre Kenny (Chair), Siobhan Manning, Anne Healy, Sinead Kennedy and Grainne McKenna.

08/12/2011 17:00:37

88 Health Matters

News // in brief Treoir launches ‘Being there for them’ for parents of unmarried parents

+ L-R: Berit Anderson, Pact; Margaret Dromey, Treoir; Andrew Montague, Lord Mayor of Dublin; Margot Doherty, Treoir; and Dr Stephanie O’Keeffe, HSE Crisis Pregnancy Programme at the launch of Being there for them.

Treoir have launched Being there for them, a booklet aimed at assisting parents of unmarried parents. Treoir, which is funded by the HSE Crisis Pregnancy Programme, provides specialist information to unmarried parents and those involved with them. Being there for them was produced as a result of the demand for information from grandparents of children whose parents are unmarried. Treoir’s specialist national information service receives over 9,000 queries a year and many of these are from grandparents. Being there for them (a phrase often used by grandparents) provides helpful hints and valuable information to parents of unmarried parents and covers topics such as: • Coping with your adult child’s unexpected pregnancy. • Having your adult children and grandchildren live with you. • Being parents of teen parents. • Providing full-time care to grandchildren. • Being grandparents who are not in touch with their grandchildren. Copies of this booklet and other Treoir publications are available free from Treoir: Email: info@treoir.ie; Tel: (01) 670 0120; LoCall: 1890 252 084. Donations towards postage are always welcome. All publications are also available to download from www.treoir.ie.

A New Initiative to Deal with Health Complaints ‘Tell us if mistakes have been made and don’t be afraid to complain’ was the key message from the launch of Healthcomplaints, a public service initiative to help members of the public understand where and how to complain about health and social care services. Healthcomplaints is a toolkit that provides information and support about how and where to make complaints on services in health or social care. It consists of a guide for the public, a leaflet, a poster, a staff training guide and the website, www.healthcomplaints.ie. To assist staff responding to queries, an Employee Guide has been produced as part of the Healthcomplaints toolkit to assist employees in understanding both their own organisation and other organisations’ roles in the management of complaints and, in turn, assist service users to deliver their complaint to the right place. A nationwide information campaign is being rolled out to hospitals, nursing homes, GP surgeries, advocacy groups and through all the agencies and organisations involved in providing health and social care.

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Awards for High Support Unit in Mountjoy Prison The High Support Unit in Mountjoy Prison has won the World Health Organisation Health in Prison – Best Practice Award and, more recently, won the Excellence in Healthcare Management category and scooped the overall prize of An Duais Mhór at the Irish Healthcare Awards, hosted by the Irish Medical Times. The ten-bed unit, which opened in December 2010, provides a dedicated area within the prison where mentally ill and vulnerable prisoners who present with a risk of harm to self or to others can be separated from the general prison population and closely monitored in a safer environment. Historically, in the Irish Prison Service, at-risk prisoners were accommodated in Special Observation Cells (SOCs) for considerable periods of time, but the use of these cells has been criticised by the Council of Europe Committee for the Prevention of Torture. The High Support Unit is staffed by trained prison officers who expressed an interest in working in this area. There is regular input from staff at the Central Mental Hospital, which includes a weekly multi-agency meeting between clinical and prison staff, and each prisoner’s treatment plan, progress and future placement is reviewed on a weekly basis. To date, over 70 prisoners have benefited from this facility and, since its establishment, the average monthly rate of occupancy of SOCs has fallen by 35 per cent.

+ Back row (L-R): Dr Damian Mohan, Fran Coughlan, Damien Harris, Fergal Black and Andy Kelly. Front row (L-R) David Williamson (Probation & Welfare), Dr Yvette Giblin, Enda Kelly and Anne Collins.

08/12/2011 17:00:52

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08/12/2011 17:00:56

90 HealtH Matters

your stories

sPorTIng PassIons Miriam Wall, senior Pharmacist at galway university Hospitals, talks to Health matters about her sporting passion: training for and competing in triathlons.

his year, Miriam has competed in the COPe sprint triathlon in salthill, winning first place overall, and the Ironman 70.3 in Galway, coming fourth in her age category among 2,000 athletes from 30 different countries, and she has cycled from Mizen to Malin Head and won the salthill relay race with her colleagues from GUH.

haVe you always Been inTo sporT? No, I only started to get fit after I had my children, Ciara, amy and Harry. I began running at this time. I was already able to swim and decided that triathlons would be better for my bones and joints. I was attracted to them because I thought the cross-training would be more varied and interesting. whaT is your Training rouTine? My training routine varies depending on the time of year. Over the winter, the intensity of training drops and the volume increases. Whereas, coming into the summer and race season, the training sessions are shorter but of a higher intensity. When I am training I try and do at least two sessions of each discipline (running, cycling and swimming) per week. Over the winter I will do some strength and conditioning training as well. whaT are you in Training For now? at the moment I am just back training after a rest following the half-ironman race in Galway. I hope to do two Ironman 70.3 races (1,900m swim, 90km cycle and 22km run) next year; the first in May, in Majorca, and the second is the World Championships in las Vegas next september. I am really excited about this after qualifying for this race at the Galway 70.3 event in september. whaT is your FaVouriTe discipline and why?

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the best thing about being a triathlete is being fit. I enjoy the training more than the competitions themselves. Of the three disciplines, I like running the most â&#x20AC;&#x201C; I think it is the endorphins I am hooked on. It is also my strongest discipline.

how long haVe you worked in guh? I have been working in the pharmacy in GUH for 11 years. I love going to work every day as my colleagues are a great bunch. My work is very interesting and varied as we interact with other healthcare professionals and patients. haVe you had a posiTiVe sporTing inFluence on any oF your colleagues? I like to think so. Many of my colleagues ask my advice on running and getting fit. also, one or two have joined the Galway triathlon Club with me. One of my colleagues, Fionnuala Baynes, cycled from Mizen to Malin with me. I am not sure who the influence for that challenge was! whaT is your sporTing highlighT? Watching the World Olympic Distance Championships in athlone in 2010. It was amazing seeing the top triathletes in the world competing at close range. It was fantastic to be able to see how the best in the world do what we try to do. It was a class event with a world-class field. whaT is your personal sporTing highlighT?

Winning the COPe sprint triathlon in Galway this year. While I have won agegroup prizes before and been runner-up in some events, I was never the first lady home in a race before. It was a great achievement and I was really proud. It made all the training worthwhile.

whaT adVice could you giVe To someone who knows ThaT They need To geT FiT and acTiVe BuT doesnâ&#x20AC;&#x2122;T know where To sTarT? I would say that where there is a will there is a way! It is important to start small and slow and to build up very slowly. a little often is better than a lot infrequently. If someone is very unfit it might be an idea to get professional advice before starting out. For everyone else, just grab your runners and start walking.

08/12/2011 17:01:03

Health Matters 91

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support a number of international and local charities, and in 2011, donated €36,000 to charities which make a significant contribution in the communities in which they operate. Although based in Dublin, membership is spread throughout the 26 counties, with members paying into their HSSCU account through Payroll Deduction (currently available in HSE East, HSE South, HSE North West) or through direct debit. We are currently seeking a payroll deduction facility from other areas of the HSE. Communication is paramount in operating a nationwide service to members and HSSCU deliver through a number of media. Members are offered online accounts, 24 hour telephone access to account information, electronic funds transfer (money transferred to the member’s bank account within 1-2 days), as well as email, a Lo Call telephone number, fax and postal services. The credit union’s website www.hsscu.ie provides a host of information for members and is updated regularly as is their Facebook page www. facebook.com/health-services-staffscredit-union. Quarterly statements and newsletters are circulated to members with news, advice, promotions, competitions, and youth section for Juniors. HSSCU promotes a positive attitude to all things financial. Its friendly staff is on hand to help alleviate any financial worries their members might have. Junior members are encouraged to learn about savings and budgeting and have account types dedicated to their age group. On a lighter note, HSSCU runs all kinds of competitions

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08/12/2011 17:01:06

92 HEALTH MATTERS

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08/12/2011 17:32:44

HealtH Matters 93

your stories

getting to

know you... NAME: Christina O'Brien JOB TITLE: acting Principal social Worker BASE: Hse Fostering Unit, Cork

How long HaVe you workeD wITH THe Hse? I’ve been with Hse south for approximately ten years and have spent most of this time working in the Fostering Department where I work with Foster Carers and social Workers. DesCrIbe your job In FIVe worDs Person-centred, making a difference, challenging. wHaT's your aVerage workIng Day lIke? there is no average day, each one is different. like life I don’t always know what the day will bring until it starts and that is one of the things I like so much about this job. a typical day for any social Worker is to be prepared for the unexpected. I’m a Manager in a social Work

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Department working with foster families. My role as manager is so varied, it could entail anything from working with a family in crisis, attending meetings, supporting social Workers and admin staff, writing reports, or getting statistics together in response to a Government enquiry. as soon as I reach the office, I’m already planning the day – who will I be meeting, what needs to be prepared, what do I need to prioritise. Phone calls start coming in from Foster Carers, social Workers and other professionals with queries, requests, complaints and good news. wHaT Do you lIke abouT your job? I really enjoy the teamwork aspect of my job – working with Foster Carers, social Workers, different professionals and families in the community. I’m working with Foster Carers who are helping make a difference in the lives of children and young people in care. IF you CoulD CHange one THIng abouT your job, wHaT woulD IT be? right now I would like to have a larger pool of Foster Carers to help meet the needs of children coming into care, especially for teenagers. wHaT's your FaVourITe book anD wHaT DID you lIke abouT IT? One of the books I’m reading at the moment is a river Called time by Mia Couto. It’s about identity and belonging, continuity and change. set in present day Mozambique, the principal narrator is

Mariano, a teenage student summoned home from his urban, westernised lifestyle to manage family affairs after the death of his grandfather. wHaT's your FaVourITe FIlm anD wHaT DID you loVe abouT IT? a film I found particularly riveting was the Butcher Boy directed by Neil Jordan. It is a funny, poignant and ultimately tragic film about a boy’s struggles with violence and mental illness. I feel this film reflects what could be the story of many of our young people who need foster placements. wHaT's THe mosT memorable THIng you HaVe eVer exPerIenCeD? Working in rwanda was one such experience. I witnessed at first hand the amazing resilience of young people who had to take on parenting roles for their younger siblings, and communities coming together again after the appalling genocide in that country. wHo Has InsPIreD you THe mosT? I have found Peter McVerry in Dublin a very inspirational figure, particularly for his work and solidarity with young people on the margins of society. ToP THIng on your Dream lIsT IF you won THe loTTo? From a professional perspective, I would like to be able to recruit more Foster Carers for older children and provide additional support and training for them.

08/12/2011 17:01:14

94 Health Matters

your stories

Under the spotlight: Me and My Lifestyle We asked Gwen Rice, Senior Community Dietitian, DNE, and Shirley O’Shea, Senior Health Promotion Officer, HSE South, to evaluate Sarah Murphy’s diet and exercise to see what she’s doing right and what steps she could take to improve her health and lifestyle.

profile Name: Sarah Murphy Region: Dublin Mid-Leinster

Do you have any particular concerns or worries regarding your lifestyle? I think I don’t get enough protein in my diet. I don’t have any set eating pattern, which I know is not good. I just go by when I’m hungry, if I’ve time or could be bothered to have a set meal. I’m more of a ‘picker’ and ‘snacker’ when it comes to eating. I would have a lot of carbohydrates in my diet for energy in an effort to improve my stamina levels, plus I love my vanilla ice-cream and I adore real butter – it’s not butter on food, it’s food on butter. I don’t think I eat enough white and red meat. However, I normally eat a substantial amount of fruit; an apple, banana or berries such as strawberries, raspberries or blueberries. What did you eat yesterday? Yesterday was a bad day when it comes to junk food. I took a leave day from work and for breakfast I had a bowl of muesli with whole Super Milk and a cup of tea. I also had an Actimel. For lunch I had a banana, half a plain croissant and some grapes on the run. I went to the movies in the late afternoon and I met a friend for a cappuccino first. During the movie, I had a white chocolate Magnum ice-cream, several pieces of fudge, chocolate squares and sugar-coated sour jellies. In the evening I had a chicken and stuffing sandwich on brown bread with

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+ Sarah Murphy in Zambia with Habitat Ireland.

another cappuccino, followed by a fruit and nut mix.

Do you exercise? On that front I don’t think I’m too bad and I’m improving at it for the moment. I’ve started a programme at the gym: I use the rowing machine, cross-trainer, leg press, step machine, bike and then weights on each visit. I aim to go to the gym at least three times weekly, and I usually try to get in some walking, swimming or horse riding during the week. Do you have any bad habits? Yeah, lots! I would say I’m a mood or timedependent eater. I go through phases of eating healthy then another phase of eating junk food, and lately I’ve developed too much of a liking for chips. I would eat a lot of cheese also, and I like a glass or two of merlot over the weekend.

“If you include some complex carbohydrates like wholegrain and granary breads, highfibre breakfast cereals, jacket potatoes, pasta or basmati rice, this can further improve your energy levels.”

08/12/2011 17:01:19

HealtH Matters 95

your stories

gwen says… I know sarah is concerned that she might not be getting enough protein in her diet, but, on taking a closer look, she may be getting more than she realises! You should try to include 2-3oz of lean beef, pork, lamb or chicken twice a day, and try to have fish at least twice a week, one of which should be oily like mackerel, trout, sardines, herring, tuna or salmon.

shirley says… sarah’s own assessment of her activity levels is “not too bad” and “improving”; however, it is interesting to note that we do tend to over estimate our fitness levels. Not only is the amount of exercise bouts important, but also the intensity of the activity. Moderate to vigorous activity is when your heart is beating faster than normal and you are breathing harder – though you should still be able to talk! seT a TargeT sarah is aiming to attend the gym for three sessions per week. If you are new

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improVing your sTamina If you have three main meals per day, you can improve your stamina levels and establish a slow release of energy throughout the day. If you include some complex carbohydrates like wholegrain and granary breads, high-fibre breakfast cereals, jacket potatoes, pasta or basmati rice, this can further improve your energy levels. sarah may be craving sugary foods to gain energy because she doesn’t have a regular meal pattern. Fruit and nut mixes, fudge, chocolate, jellies and ice-cream all have a high sugar content and should only be included in the diet as a treat. Muesli is high in fibre but can also be high in sugar. sarah could try alternatives like porridge, Weetabix, all-Bran or shredded Wheat instead. ldl cholesTerol is Bad cholesTerol It might be a good idea for sarah to visit her GP to have her cholesterol levels checked.

to using the gym, it’s a good idea to set a target on how many times a week you can realistically commit to – and keep your gear handy! sarah’s gym programme has a good balance of cardiovascular equipment for aerobic fitness and weights, which will help to improve her strength and muscle tone. I would suggest adding in a gentle warm-up, especially on cold nights, using the step machine or bike and increasing pace after five or ten minutes. It’s also a good idea to stretch the main muscle groups you have used after a workout. sarah does not mention drinking any water as part of her day, which is important when exercising and a good daily habit to get into.

Butter should be limited to very small amounts on special occasions. Foods such as butter, cheese, croissants and chips are high in saturated fats, which can have a direct effect on increasing lDl (low-density lipoprotein) cholesterol and can lead to a heart attack or stroke. In contrast, foods high in monounsaturated fats such as Olivio, Golden Olive or lowlow spreads we can improve HDl (healthy) cholesterol levels. However, no matter what type of fat you eat, it all has the same calories, so one heaped teaspoon of low-fat spread is enough for two slices of bread.

low-FaT dairy producTs You need three portions of dairy a day to provide your daily calcium needs, but remember to choose low-fat varieties. low-fat cheese is lower in saturated fat, but you still need to watch the amount you eat, so have no more than a few 1-2oz portions per week.

programme for outdoor activities such as bike riding, Nordic walking or jogging with a group. the Hse have just launched a website, www.getirelandactive.ie, whice is a onestop information source on how to get involved in physical activity in Ireland.

long-Term goal sarah could benefit from having a longterm exercise goal to keep focused and to give her a sense of achievement. Her gym programme is complemented with recreational activity like horse riding, which is great cardiovascular exercise. On the days she does not go to the gym, sarah could increase her opportunities for exercise by going for a brisk 30-minute walk at lunch-time or after work.

mix iT up One of the biggest factors in keeping people motivated is variety. Gym programmes can become boring if you do the same routine each time. Gym instructors can help vary a programme, or suggest other exercises and machines. Joining a class in a gym is another good way to keep interested. In the summer months, sarah could swap her gym

08/12/2011 17:01:30

96 HealtH Matters

your stories

a Day In THe lIFe Caroline Daly takes us through her day as a Consultant Cardiologist at st james’s Hospital, where she is in the process of leading the establishment of a new Heart support unit.

got up at 6.30am and had breakfast with my children before coming to work. I live in Castleknock so it’s a lovely cycle through the Phoenix Park to st James’s. I reached the hospital at 7.45am and spent 15 minutes checking emails before starting the ward round with my registrar, senior House Officer and the senior Nurses on each ward. We started on the Coronary Care Unit where the most acutely ill patients are, followed by the Cardiac Ward and the Chest Pain assessment Unit. today we also had two patients who were still in the emergency Department awaiting transfer to a ward bed. among the new patients admitted today were a middle-aged man with a threatened heart attack (it had been averted by early presentation and a trip to the Cath lab for an angiogram and stent), an elderly lady with a slow heart rate who needed a pacemaker, a lady with a leaking valve which had caused her lungs to fill with fluid, and others with chest pain which may or may not turn out to be heart-related pending the results of further investigation. at 10am, after the ward round, I went to the Cardiac Cath lab to discuss inpatients awaiting procedures and to plan the order of priority. then I supervised a trainee in the Intensive Care Unit doing a trans-oesophageal echo on a patient with suspected endocarditis, before meeting with one of my radiology colleagues to jointly report on cardiac imaging studies. at 1pm I had a research meeting with colleagues to discuss a new project we are starting that will focus on cardiac MrI for patients with HIV. Following this I had a meeting with the Deputy CeO about the new Heart support Unit that my colleagues and I are trying to establish to provide structured support and rehabilitation for patients who have heart failure. the service is in its infancy, but we have one specialist Nurse in place, awaiting a second, and are working on establishing

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It and other ancillary supports for the service. the logistics of establishing a service are not straightforward in the current economic climate when the hospital management is besieged with requests for funding. thankfully, we have a progressive Management team who have very much taken on board the need to provide better ambulatory care for patients with chronic disease such as heart failure to improve their quality of life and reduce readmissions, but there are real challenges to funding and we are very fortunate that the st James’s Hospital Foundation has selected the Heart support

“one of the most enjoyable features of working in cardiology is the fact that there are so many highly effective procedures and drug treatments so, for the majority of patients, they can leave hospital feeling better after a relatively short stay.”

Unit as a focus of its fundraising. after the meeting with the Deputy CeO it was back to the Cath lab, where I inserted the pacemaker for the lady with the slow heart rate and then carried on performing angiograms on patients who had been admitted to st James’s or transferred from other referring hospitals. In the late afternoon I discussed cases with my interventional colleague, the cardiologist expert in placing stents, and arranged the Cath lab list for the following day. after 5pm I met with the registrar on duty for consults to review patients with cardiac issues admitted under other specialties, before reviewing two patients in Coronary Care who had been unstable during the day. after a final quick check of emails and messages in my office, it was home-time at 8pm. My day is never fixed and always rewarding. One of the most enjoyable features of working in cardiology is the fact that there are so many highly effective procedures and drug treatments so, for the majority of patients, they can leave hospital feeling better after a relatively short stay.

08/12/2011 17:01:35

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06/12/2011 18:54:39

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06/12/2011 18:55:13